The potential application value of bile acid mass spectrometry detection technology in the differential diagnosis of biliary atresia
10.3760/cma.j.issn.1673-4912.2025.07.003
- VernacularTitle:胆汁酸质谱检测技术在胆道闭锁鉴别诊断中的潜在应用价值
- Author:
Lijuan ZHENG
1
;
Xiaoxiao XU
;
Jing YU
;
Teng LIU
Author Information
1. 郑州大学附属儿童医院 河南省儿童医院郑州儿童医院消化内科 450018
- Publication Type:Journal Article
- Keywords:
Blood bile acid spectrum;
Biliary atresia;
Differential diagnosis;
Children
- From:
Chinese Pediatric Emergency Medicine
2025;32(7):495-499
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical blood bile acid spectrum detection results of patients with biliary atresia（BA）and non-BA cholestasis,and to clarify the distribution changes of major bile acids in the serum of BA patients and their potential differential diagnostic value.Methods:The serum bile acid concentrations of BA and other non-BA cholestasis patients in the same age who underwent clinical bile acid spectrum testing at Children's Hospital of Fudan University from September 2019 to September 2020 were retrospectively analyzed.Non-BA patients were divided into the low gamma-glutamyl transpeptidase (GGT) cholestasis group (33 cases) and the high GGT cholestasis group (19 cases) based on serum GGT levels.ROC curve was used to analyze the differences in bile acid concentration levels between BA and non-BA patients,and their potential differential diagnostic value for BA.Results:(1) A clinical bile acid spectrum was collected from 74 BA patients and 52 non-BA patients.The median level of primary bile acid concentration in the BA group increased,ranging from 4.8 to 46.7 times the upper limit of the normal reference value.In the BA group,the median levels of all secondary bile acid concentrations decreased,ranging from 1/660 to 1/1.1 of the upper limit of the normal reference value.(2) The concentrations of glycocholic acid(GCA) and taurocholate (TCA) in the BA group were higher than those in the high GGT cholestasis group and the low GGT cholestasis group( P<0.05).(3) ROC curve analysis showed that when the GCA concentration>8 690 nmol/L,the AUC value was 0.706 (95% CI 0.609-0.803),with a sensitivity of 0.811,specificity of 0.538,positive predictive value of 0.714,and negative predictive value of 0.667. Conclusion:An obstruction of bile salt secretion in the bile duct,leading to a decrease in secondary bile acid production in the intestine.A significant decrease in secondary bile acid levels,accompanied by a significant increase in GCA concentration may suggest BA.
