To screen and validate key biomarkers associated with liver fibrosis progression and prognosis in biliary atresia (BA).
Approach:
Data Analysis: Analyzed the public transcriptomic dataset GSE122340 to identify differentially expressed genes and constructed a protein–protein interaction (PPI) network.
Clinical Sample Verification: Collected clinical samples from BA patients and a control group to verify ECT2 expression using immunohistochemistry, qPCR, and ELISA.
Predictive Efficacy Assessment: Performed ROC curve analysis to evaluate serum ECT2 levels for BA diagnosis, fibrosis stratification, and postoperative survival prediction.
Survival Analysis: Conducted Kaplan–Meier curve analysis to assess the relationship between serum ECT2 levels and postoperative native liver survival.
Key Findings:
Serum ECT2 demonstrated favorable efficacy in BA diagnosis (AUC = 0.906), fibrosis stratification (AUC = 0.807), and predicting 2-year postoperative native liver survival (AUC = 0.844). Compared with MMP7, ECT2 shows comparable predictive performance in the diagnosis of BA (AUC = 0.924) and the stratification of liver fibrosis (AUC = 0.829), and outperforms MMP7 in predicting autologous liver survival (AUC = 0.767).
ECT2 outperformed traditional liver function markers and showed superior predictive performance compared to MMP7.
Interpretation:
ECT2 is a promising non-invasive biomarker for assessing liver fibrosis and prognosis in biliary atresia, supported by its significant expression levels and predictive efficacy.
Limitations:
The study's sample size was limited to 20 BA cases and 10 controls, which may affect the generalizability of the findings.
Further validation in larger cohorts is needed to confirm the clinical utility of ECT2 as a biomarker.
Conclusion:
ECT2 is characteristically highly expressed in BA and is associated with disease severity and prognosis.
