Accurate prediction of biliary atresia with an integrated model using MMP-7 levels and bile acids  

作　　者：Yi-Jiang Han Shu-Qi Hu Jin-Hang Zhu Xiao Cai Deng-Ming Lai Bao-Hai Chen Kun Zhu Qiao Tong Xin-Rui Zhou Jia-Le Deng Jin-Fa Tou Zhuo Fang Li-Zhong Du 

机构地区：[1]Department of Neonatal Surgery,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,China [2]Department of Data and Analytics,WuXi Diagnostics Innovation Research Institute,Shanghai,China [3]Department of Information Center,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,China [4]Department of Pathology,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,China [5]Department of Neonatology,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,China

出　　处：《World Journal of Pediatrics》2024年第8期822-833,共12页世界儿科杂志（英文版）

基　　金：supported by a grant from the Key Program of the Independent Design Project of National Clinical Research Center for Child Health(Grant no.S20C0004);Shanghai Pujiang Program(21PJ1423100);Ministry of Industry and Information Technology Artificial Intelligence Medical Devices Innovation Program.

摘　　要：Background Biliary atresia(BA)is a rare fatal liver disease in children,and the aim of this study was to develop a method to diagnose BA early.Methods We determined serum levels of matrix metalloproteinase-7(MMP-7),the results of 13 liver tests,and the levels of 20 bile acids,and integrated computational models were constructed to diagnose BA.Results Our findings demonstrated that MMP-7 expression levels,as well as the results of four liver tests and levels of ten bile acids,were significantly different between 86 BA and 59 non-BA patients(P<0.05).The computational prediction model revealed that MMP-7 levels alone had a higher predictive accuracy[area under the receiver operating characteristic curve(AUC)=0.966,95%confidence interval(CI):0.942,0.989]than liver test results and bile acid levels.The AUC was 0.890(95%CI 0.837,0.943)for liver test results and 0.825(95%CI 0.758,0.892)for bile acid levels.Furthermore,bile levels had a higher contribution to enhancing the predictive accuracy of MMP-7 levels(AUC=0.976,95%CI 0.953,1.000)than liver test results.The AUC was 0.983(95%CI 0.962,1.000)for MMP-7 levels combined with liver test results and bile acid levels.In addition,we found that MMP-7 levels were highly correlated with gamma-glutamyl transferase levels and the liver fibrosis score.Conclusion The innovative integrated models based on a large number of indicators provide a noninvasive and cost-effective approach for accurately diagnosing BA in children.

关 键 词：Bile aid.Biliary atresia Diagnosis Liver fibrosis Liver test MMP-7 

分 类 号：R725.7[医药卫生—儿科]