期刊
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
卷 77, 期 1, 页码 97-102出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MPG.0000000000003792
关键词
biliary atresia; cholestasis; matrix metalloproteinase-7; osteopontin
This study aimed to assess the diagnostic accuracy and prognostic value of matrix metallopeptidase-7 (MMP-7) and osteopontin (OPN) in biliary atresia (BA). The results showed that both MMP-7 and OPN may have contributory value in the diagnosis of BA, but they are far from being the gold standard. More prospective data and collaborative multi-center initiatives are needed to further validate their effectiveness.
Objectives: Matrix metallopeptidase-7 (MMP-7) and osteopontin (OPN) are important components in the pathophysiology of fibrosis in biliary atresia (BA). There has been much recent interest in MMP-7 serum level in the diagnosis of BA. We aimed to assess the diagnostic accuracy and prognostic value of both MMP-7 and OPN in a Western BA study. Methods: Diagnostic value was assessed by comparison of serum MMP-7 and OPN levels in infants with BA and age-matched cholestatic controls. Prognostic value was assessed through subsequent clearance of jaundice (COJ) and need for liver transplantation (LT). Results: Serum was assessed from 32 BA and 27 controls. Median MMP-7 was higher in BA (96.4 vs 35 ng/mL; P < 0.0001) with an optimal cut-off value of 69 ng/mL. Sensitivity and specificity was 68% and 93%, respectively [negative predictive value (NPV) = 71%]. Similarly, median OPN was higher in BA (1952 vs 1457 ng/mL; P = 0.0001) and an optimal cut-off of 1611 ng/mL. Sensitivity and specificity was 84% and 78%, respectively (NPV = 81%). MMP-7 level correlated positively with Ishak liver fibrosis score (r = 0.27, P = 0.04). Neither MMP-7 (70 vs 100 ng/mL; P = 0.2) nor OPN (1969 vs 1939 ng/mL; P = 0.3) were predictive of COJ, or need for LT (99 vs 79 ng/mL; P = 0.7, and 1981 vs 1899 ng/mL; P = 0.2), respectively. Conclusions: MMP-7 and OPN may have contributory value in the diagnosis of BA, but remain far of the gold standard role. Much more prospective data are required and collaborative multi-center initiatives should be the next logical steps.
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