ABSTRACT
Hepatocellular carcinoma [HCC] is the third most frequent cause of cancer mortality among men worldwide. Serotonin is a biogenic amine, ligand of a family of 5-HT receptors that reflect the diversity of serotonergic actions. Majority of serotonin in body [90%] is synthesized by enterochromaffin cells of the gastrointestinal tract and is exported to various sites. Serotonin regulates blood flow and vascular tone at portal and sinusoidal levels, serotonin acts as a mitogen for hepatocytes and promotes liver regeneration. 5HT emerges as a mediator of different pathological conditions [double edged sword]. It contributes to liver fibrosis, mediates oxidative stress in nonalcoholic steatotic hepatitis and aggravates viral hepatitis, these conditions are involved in tumourigenesis of hepatocellular carcinoma [HCC]. Impaired metabolic function in liver cirrhosis and slow uptake and storage of serotonin by the platelets is a sequelae of kinetic change of serotonin transport mechanisms or abnormal serotonin release from dense granules of activated platelets is a condition defined as ''platelet exhaustion'', contributes to elevated plasma serotonin which may facilitate tumour growth of primary liver hepatocellular carcinoma. To determine whether serotonin is a marker for the diagnosis of hepatocellular carcinoma in cirrhotic patients. Patients were classified into two groups; 45 patients with cirrhosis only and 30 patients with cirrhosis and HCC. Ten healthy subjects were taken as controls. Patients underwent; full history taking, clinical examination, and abdominal ultrasonography. Laboratory methods include SGOT, SGPT, GGT, bilirubin, alkaline phosphatase, total proteins, albumin, CBC, prothrombin, INR, APRI score, Child-pugh score, MELD score, AFP and serum serotonin. Plasma serotonin was significantly higher in the patients group with cirrhosis with a median level of 119.4 ng/ml than in the control group which showed a median value of 51.5 ng/ml p< 0.001. A significance difference was also seen between cirrhosis and the HCC group with a median value of 478.35 ng/ml than the control group and a cirrhosis group with p< 0.001was found. Plasma serotonin level was significantly higher in patients with cirrhosis and HCC than in those with cirrhosis only and it was involved in the tumourigenesis of hepatocellular carcinoma