The value of serum MMP-7 and SOX9 levels in the diagnosis and prognosis of biliary atresia

To investigate the diagnostic value of serum MMP-7 and SOX9 levels in patients with biliary atresia (BA) and to further analyze their relationship with the liver fibrosis and prognosis. Sixty-eight patients hospitalized for jaundice and underwent surgical treatment from March 2019 to February 2022 were retrospectively analyzed, including 44 patients with BA and 24 patients with other cholestatic liver diseases as disease controls (DC). Serum levels of MMP-7 and SOX9 were detected using enzyme-linked immunosorbent assay (ELISA). The diagnostic value of MMP-7 and SOX9 for BA was evaluated using the receiver operating characteristic (ROC) curve. Serum levels of MMP-7 and SOX9 were higher in the BA group compared to the DC group (P = 0.0002, P = 0.0006). The AUC for the combined diagnosis of serum MMP-7, SOX9 and GGT was 0.888 (95% CI:0.788-0.952, P < 0.0001), which was significantly different from the diagnosis of MMP-7 or SOX9 alone (P = 0.034, P = 0.030). Serum levels of MMP-7 and SOX9 were significantly positively correlated with the liver fibrosis score (rs = 0.41, P = 0.006; rs = 0.58, P < 0.0001). BA patients who maintained native liver survival had lower preoperative serum levels of MMP-7 and SOX9 (P = 0.008, P = 0.0008). The combined diagnosis of BA by MMP-7, SOX9 and GGT has better accuracy than MMP-7 or SOX9 alone. Serum SOX9 levels can assess the severity of BA liver fibrosis and correlate with BA native liver survival, but more sample data are needed to further investigate its predictive value.