[Diagnostic value and clinical significance of matrix metalloproteinase-7, gamma-glutamate transferase, and liver stiffness measurement with ultrasound elastography in children with biliary atresia].

Objective: To investigate the diagnostic value and clinical significance of matrix metalloproteinase-7 (MMP-7), gamma-glutamyl transferase (GGT), and liver stiffness measurement (LSM) with ultrasound elastography in children with biliary atresia (BA). Methods: A retrospective study was conducted. Forty-five children diagnosed with cholestasis at the Guiyang Maternal and Child Health Hospital between January 2022 and February 2025 were selected as the study subjects. All subjects underwent clinical examination. Pre-enrollment diagnoses were thoroughly documented. The children were divided into a BA group (n=20) and a non-BA group (n=25) based on intraoperative cholangiography and follow-up results. The levels of MMP-7, GGT, direct bilirubin (DBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, total bile acids, and LSM were compared between the two groups. Indicators with statistically significant differences were used to plot and calculate receiver operating characteristic (ROC) curves. The model's stability was internally validated by the bootstrap method. Continuous variables were compared using t-tests or rank-sum tests. Categorical variables were analyzed using χ2 tests. The highest observed effect size among all indicators, matrix metalloproteinase-7 (effect size d≈2.5), with an α error probability set at 0.05 was determined using the G*Power 3.1 software. The statistical reliability of the present sample size (BA group n=20, non-BA group n=25) was analyzed using the efficacy calculation model of the Mann-Whitney U test (two independent samples). Results: The levels of MMP-7 [38.95 (17.50, 58.75) μg/L vs. 6.00 (6.00, 7.00) μg/L], GGT [492.04 (237.92, 611.25) U/L vs. 166.00 (86.95, 220.00) U/L], DBil [139.16 (122.62, 164.45) µmol/L vs. 100.90 (62.90, 149.90) µmol/L], and LSM [12.0 (10.0, 17.5) kPa vs. 7.0 (6.0, 8.0) kPa] were significantly higher in the BA group than those in the non-BA group, and the differences were statistically significant (P<0.05). MMP-7 as a single indicator demonstrated extremely high diagnostic efficacy in BA diagnosis, with an area under the ROC curve of 0.987. Combining MMP-7 with DBil and LSM further enhanced diagnostic efficacy, achieving a combined AUC of 0.990. The bootstrap method had validated the model as stable and reliable. The statistical power analysis indicated that with the present study sample size, key diagnostic indicators, such as MMP-7, were >0.99. Conclusion: MMP-7, GGT, DBil, and LSM have significant value in the diagnosis of BA. Among them, MMP-7 serves as an independent biomarker with the highest diagnostic efficacy, while combining it with LSM and DBil further improves diagnostic efficacy.