Background: Venous thromboembolic disease (VTE) remains a significant source of morbidity and mortality. As non-specific subjective complaints and a lack of objective clinical examination findings complicate the diagnosis of both deep venous thrombosis (DVT) and pulmonary embolism. Objective diagnostic testing is required to confirm or exclude the presence of venous thromboembolism before subjecting patients to unnecessary long-term anticoagulation. Aim of the Work: This study was aimed to measure the level of soluble P-selectin (sPsel) in Egyptian patients with DVT and asses its diagnostic value in relation to other clinical data and radiological examination. Subjects and Methods: This study was carried out on 80 individuals, attending Ain Shams University Hospitals between October 2015 and March 2016 after Ethical committee approval. They were divided into two groups.: Group I, 50 patients who were positive for DVT by duplex ultrasound. They were 41 males and 9 females. Their ages ranged 20 - 77 years, with a mean of 46.20 ± 11.78 years. They were 41 (82%) males and 9 (18%) females, with a male to female ratio of 4.55:1. Group II: 30 healthy subjects with no clinical signs, symptoms, or history of DVT. They were 23 (76.7%) males and 7 (23.3%) females, with a male to female ratio of 3.28:1. Results: There was a highly significant difference between patients (group I) and controls (group II) as regards P-selectin, the best cut off was70.5 ng/ml with 98% sensitivity, 100% specificity, a NPV of 96.8% and a PPV of 100%.
Conclusion: Diagnostic cut-off levels of P-selectin in cases with DVT is 70.5 mg/L that can safely differentiate patients who are free from DVT from others who are positive for DVT or those who would eventually develop thrombosis regardless their primary duplex ultrasound scanning results. Recommendations: As our study recommends the use of serum P-selectin as diagnostic biomarker in DVT alone; in addition to the newly estimated cut-off levels for these biomarker, further studies on larger number of cases are needed for more evaluation of these cut-off values and to establish whether they could be used to guide anticoagulation therapy when duplex ultrasound is unavailable.