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

Autor: Han YJ; Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China., Hu SQ; Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China., Zhu JH; Department of Data and Analytics, WuXi Diagnostics Innovation Research Institute, Shanghai, China., Cai X; Department of Data and Analytics, WuXi Diagnostics Innovation Research Institute, Shanghai, China., Lai DM; Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China., Chen BH; Department of Information Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China., Zhu K; Department of Pathology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China., Tong Q; Department of Data and Analytics, WuXi Diagnostics Innovation Research Institute, Shanghai, China., Zhou XR; Department of Data and Analytics, WuXi Diagnostics Innovation Research Institute, Shanghai, China., Deng JL; Department of Data and Analytics, WuXi Diagnostics Innovation Research Institute, Shanghai, China., Tou JF; Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China. toujinfa@zju.edu.cn., Fang Z; Department of Data and Analytics, WuXi Diagnostics Innovation Research Institute, Shanghai, China. fang_zhuo@wuxidiagnostics.com., Du LZ; Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China. dulizhong@zju.edu.cn.
Jazyk: angličtina
Zdroj: World journal of pediatrics : WJP [World J Pediatr] 2024 Aug; Vol. 20 (8), pp. 822-833. Date of Electronic Publication: 2023 Dec 23.
DOI: 10.1007/s12519-023-00779-7
Abstrakt: 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. Video Abstract (MP4 142103 KB).
(© 2023. The Author(s).)
Databáze: MEDLINE
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