title: Could serotonin be a potential marker for hepatocellular carcinoma? A prospective single-center observational study.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is the third most common cause of cancer mortality among men worldwide. Serotonin is a biogenic amine, which may be involved in the tumorigenesis of HCC.
  
  
  OBJECTIVE
  We aimed to determine whether serotonin is a dependable marker for the diagnosis of HCC in cirrhotic patients in comparison with α-fetoprotein protein (AFP) and prothrombin induced by vitamin K absence-II (PIVKA-II).
  
  
  METHODS
  Serum serotonin, AFP, and PIVKA-II were measured in 262 patients with chronic hepatitis C (CHC): 82 cirrhotic patients with HCC (group I), 80 cirrhotic patients without HCC (group II), and 100 CHC-infected patients without cirrhosis (group III); in addition, 60 healthy controls were studied (group IV).
  
  
  RESULTS
  AFP showed significant statistical differences among the groups studied (P<0.001). PIVKA-II and serotonin levels showed no statistically significant differences between the patients with CHC group and the healthy controls (P1=0.614 and P1=0.13, respectively), whereas their levels were statistically higher in cirrhotic patients than patients with CHC (all P values <0.001) and in the cirrhotic patients with HCC group than the cirrhotic patients without HCC (P<0.001). A significant positive correlation was found between serum serotonin and AFP (rho=0.794; P<0.001) and serum serotonin and PIVKA-II (rho=0.889; P<0.001) among the patient groups. The receiver operator characteristic curve showed a higher area under the curve for serotonin than AFP and PIVKA-II (0.942, 0.824, and 0.921, respectively).
  
  
  CONCLUSIONS
  Serotonin may be used together with PIVKA-II to screen for HCC in cirrhotic patients with CHC.
authors.affiliation: Departments of aTropical Medicine bClinical Pathology cDiagnostic & Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel-Razik
authors.forename: Rania
authors.initials: R
authors.lastname: Elhelaly
authors.forename: Rasha
authors.initials: R
authors.lastname: Elzehery
authors.forename: Amany
authors.initials: A
authors.lastname: El-Diasty
authors.forename: Sally
authors.initials: S
authors.lastname: Abed
authors.forename: Dina
authors.initials: D
authors.lastname: Elhammady
authors.forename: Ahmed
authors.initials: A
authors.lastname: Tawfik
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000821:virology; D016022:Case-Control Studies; D004534:Egypt; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000821:virology; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012701:Serotonin / Q000097:blood*; D015854:Up-Regulation; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; D012701:Serotonin; C008208:acarboxyprothrombin; D011516:Prothrombin