Hu Shuqi,Han Yijiang,Zhao Xiaoxia,et al.Prognostic value of preoperative serum levels of MMPs in children of biliary atresia[J].Journal of Clinical Pediatric Surgery,,():723-728.[doi:10.3760/cma.j.cn101785-202405079-005]
Prognostic value of preoperative serum levels of MMPs in children of biliary atresia
- Keywords:
- Biliary Atresia; Matrix Metalloproteinases; Hepatic Fibrosis; Jaundice; Cholangitis; Survival Rate; Correlation of Data
- Abstract:
- Objective To explore the correlation between preoperative serum matrix metalloproteinases (MMPs) levels and liver fibrosis, as well as the jaundice clearance rate, early cholangitis, and medium-to-long-term native liver survival following the Kasai procedure in children with Type Ⅲ biliary atresia, in order to identify predictive factors for the prognosis of biliary atresia after Kasai surgery.Methods A retrospective analysis was conducted on the preoperative serum MMPs protein levels of children diagnosed with Type Ⅲ biliary atresia who underwent the Kasai procedure at the Department of Neonatal Surgery, Children’s Hospital, Zhejiang University School of Medicine,procedure from March 2017 to June 2018. Postoperative data included liver pathology, jaundice resolution at 3 months, early cholangitis, and 5-year native liver survival. Serum MMPs levels were analyzed in relation to different prognostic outcomes.Results A total of 38 children were included in this study, including 22 males and 16 females. 3 children, diagnosed with Type Ⅲ biliary atresia intraoperatively, had their families refuse the Kasai procedure and only underwent liver biopsy. Of the 35 patients who proceeded with the Kasai procedure and liver biopsy, 6 underwent liver transplantation within 1 year post-surgery, 2 died due to biliary atresia-related complications, and 27 survived with native liver for over 5 years. There were no statistically significant differences in preoperative serum MMPs levels between the jaundice resolution and non-resolution groups, or between the native liver survival and non-survival groups. However, preoperative serum MMP-7 levels were significantly higher in the early cholangitis group (29 967.89±15 079.03 pg/mL) compared to the non-cholangitis group (15 071.77±10 988.75 pg/mL)(t=2.978,P<0.05). For liver fibrosis, MMP-7 levels were higher in the severe fibrosis group compared to the mild fibrosis group (Z=-2.285,P<0.05). MMP-13 levels were lower in the severe fibrosis group compared to the mild fibrosis group (Z=-1.972,P<0.05).Conclusions Preoperative serum MMP-7 and MMP-13 levels are associated with early cholangitis and the degree of liver fibrosis after Kasai surgery in children with biliary atresia, and may as potential prognostic markers.
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Memo
收稿日期:2024-5-30。
基金项目:2020年度国家中心自主设计项目(SZOC0004)
通讯作者:钭金法,Email:toujinfa@zju.edu.cn