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Abstract Background:Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer. HCC is a major health problem in Egypt and ranked as the sixth most common neoplasm and the third leading cause of death Serotonin (5-HT) is a monoamine neurotransmitter that is primarily found in the gastrointestinal tract and central nervous system.It can be used as a highly sensitive biomarker for early diagnosis of HCC compared to AFP. Objectives: To determine the role of serum serotonin level as abiomarker in the diagnosis and early of detection of HCC. Methods: This study included 75 patients (49 HCC patients and 26 patients with liver cirrhosis), 25 healthy subjects of matching age and gender were included as a control group.Serum serotonin level was measured to all using high performance liquid chromatography (HPLC) technique. Results: This study revealed that serum serotonin level was significantly elevated in early HCC patients compared with late HCC, cirrhosis and control group (p value = < 0.001). Conclusion: serum serotonin should be included in the screening programs for early HCC detection among cirrhotic patients as a rapid, sensitive, noninvasive and cost{u2013} effective diagnostic biomarker |