A comprehensive diagnostic model based on serum MMP-7: a convenient and efficient early diagnostic method for biliary atresia.

OBJECTIVE: To evaluate the diagnostic value of serum matrix metalloproteinase‑7 (MMP‑7) in biliary atresia (BA) and to develop a predictive model for its early diagnosis. METHODS: We conducted a retrospective study of 145 infants with cholestasis who were treated at Beijing Children’s Hospital between 2019 and 2025. The cohort included 102 BA and 43 non‑BA cases. Preoperative levels of MMP‑7, liver stiffness measurement (LSM), and clinical indicators were compared between the two groups. Independent risk factors were identified using logistic regression. A predictive model was constructed and validated. The diagnostic performance was assessed by receiver operating characteristic (ROC) curve analysis. RESULTS: MMP‑7, LSM, γ‑glutamyl transferase (GGT), and other clinical variables differed significantly between the BA and non‑BA groups. Acholic stools (odds ratio [OR] = 7.60), MMP‑7 (OR = 1.08), and GGT (OR = 1.01) were identified as independent predictors of BA. MMP‑7 alone showed high diagnostic accuracy, with an area under the ROC curve (AUC) of 0.92 in the overall cohort, 0.94 in neonates, and 0.92 in older infants. A combined model incorporating MMP‑7, GGT, and acholic stools achieved AUCs of 0.95 in the training set and 0.97 in the validation set. CONCLUSION: Serum MMP‑7 is a reliable non‑invasive biomarker for BA. A diagnostic model that combines MMP‑7, GGT, and acholic stools improves early diagnostic accuracy and may facilitate timely surgical intervention.