The diagnostic accuracy of MMP-7 for the diagnosis for biliary atresia- a systematic review and meta-analysis.

BACKGROUND

Matrix metalloproteinase-7 (MMP-7) has emerged as a promising biomarker for the early detection of biliary atresia (BA), with potential to significantly improve diagnostic accuracy and patient outcomes. This meta-analysis evaluated the diagnostic performance of MMP-7 to determine its clinical utility in the identification of BA.

METHODS

A comprehensive literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Library for studies published through March 21, 2024. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Diagnostic parameters including sensitivity, specificity, likelihood ratios, and diagnostic odds ratios were pooled. Summary receiver operating characteristic curves were constructed to evaluate overall diagnostic performance.

RESULTS

9 studies comprising 710 patients were included in the analysis. MMP-7 demonstrated a pooled sensitivity of 0.80 (95% CI: 0.58-0.92) and specificity of 0.97 (95% CI: 0.90-0.99), with an area under the curve of 0.97 (95% CI: 0.95-0.98). Subgroup analyses by geographic sample size, study type and mean/median age revealed no significant differences in diagnostic performance. An inverse relationship was observed between cutoff values and sensitivity, with higher thresholds yielding lower sensitivity but improved specificity.

CONCLUSION

The sensitivity of MMP-7 is influenced by sample processing methods, sample handling time, and substantial variability in cutoff values. Therefore, it cannot serve as an independent diagnostic tool for BA, and BA diagnosis should continue to rely on the gold standard. However, MMP-7 may serve as a valuable tool for risk stratification in BA. Future research should investigate the diagnostic performance of MMP-7 across varying cutoff values, reflecting the observed variability across studies.

PROSPERO REGISTRATION NUMBER

CRD42024532998.