Background: Serotonin known to be a neurotransmitter
can regulate several key aspects of liver biology.
Aims: This study aimed to determine the role of serum
serotonin levels (5-HT) as a non-invasive marker in the
prediction of esophageal and fundal varices in cirrhotic
patients.
Patients and Methods: The study included seventy cirrhotic
patients with hepatitis C virus and fifteen apparently healthy
subjects as a control group. Patients were further sub-classified
according to upper Gastrointestinal Endoscopy into three
groups: Group A: Included 30 cirrhotic patients without
esophageal varices (OV), Group B: Included 29 cirrhotic
patients with OV, Group C: Included 11 cirrhotic patients
with OV and fundal varices. All subjects were subjected to
full history taking, clinical evaluation, routine laboratory
investigations and serum-serotonin by ELISA.
Results: The mean level of serum Serotonin showed a
gradual increase in cirrhotic patients with the highest level
in oesophageal and fundal varices (94.04±8.51ng/ml), followed
by patients with oesophagal varices only (39.2±18.38ng/ml),
and both groups were significantly increased than the patient
group with no oesophageal varices. There was a positive
correlation between serum serotonin level and serum creatinine
level, presence and grading of oesophagal varices and the
presence of fundal varices. Serum serotonin level at a cutoff
value 32.2ng/ml had a sensitivity of 72% and a specificity of
60% in prediction of OV in cirrhotic patients but at cutoff
level 28.4ng/ml had low sensitivity (55%) and bad specificity
(25%) in discrimination between grads of OV, while serum
serotonin level at a cutoff value 79.1ng/ml had a sensitivity
of 100% and a specificity of 96.6% to diagnose patients with
oesophagal and fundal varices. Applying multivariate analysis,
serum serotonin level was an independent predictor for
oesophagal varices.
Conclusion: Serum serotonin levels could be used as a
serum non-invasive marker for the presence of gastrooesophageal
varices, but it could not discriminate between
the grades of oesophageal varices. |