Abstract
ObjectiveTo determine the expression of neuron-specific enolase (NSE) in patients with multiple myeloma (MM) and to evaluate its clinical value as a tumor marker and, an indicator of disease progression and treatment efficacy.MethodsUsing electrochemiluminescence immunoassay (ECLIA), we measured the serum levels of NSE in 47 healthy subjects (control group), 25 patients with small cell lung cancer (lung cancer group), and 52 patients with MM (MM group). For the MM group, serum NSE levels were measured and other disease indicators and related symptoms were monitored before and after chemotherapy. The relationship between NSE expression and other MM-related factors was analyzed. In addition, immunohistochemical staining was performed on bone marrow biopsy specimens from patients with MM.ResultsIn the control group, serum NSE levels were within the normal range as previously reported, while the lung cancer group and the untreated MM group exhibited NSE levels that were significantly higher relative to the control group (P<0.05). The difference in NSE expression between the lung cancer group and untreated MM group was statistically significant (P<0.05). NSE levels were significantly decreased in MM patients after chemotherapy and were positively correlated with an MM disease index [beta-2 microglobulin (β2-MG)]. Changes in NSE were not related to the response rate to chemotherapy but rather were correlated with progression-free survival.ConclusionsPatients with MM may have increased serum NSE levels, and changes in NSE may provide insight into treatment efficacy of chemotherapy and disease progression. Perhaps NSE expression is a viable biomarker for MM and can be a useful reference for the design and adjustment of clinical MM treatment programs.
Highlights
Multiple myeloma (MM) is a malignant plasma cell disease typified by clonal plasma cells in the bone marrow and is associated with end-organ damage, including bone damage, and the presence of monoclonal protein (M protein) in the serum or urine [1,2,3,4]
We examined the level of neuron-specific enolase (NSE) in 52 MM patients before and after chemotherapy
2 Comparison of serum NSE levels between the control and small cell lung cancer groups (Table 2) As shown in Table 2, the serum NSE level in the control group all fell within the normal range, whereas the level in lung cancer group were significantly higher at the level of third percentile (P, 0.05)
Summary
Multiple myeloma (MM) is a malignant plasma cell disease typified by clonal plasma cells in the bone marrow (plasma cell neoplasms) and is associated with end-organ damage, including bone damage, and the presence of monoclonal protein (M protein) in the serum or urine [1,2,3,4]. Treatment efficacy and recurrence can be monitored by measuring the proportion of plasma cells in bone marrow by puncture or biopsy, M protein levels in serum and urine, immune electrophoresis, and the range, number and progression of osteolytic lesions [5]. The levels of blood beta-2 microglobulin (b2-MG), albumin, and urine light chain are used to determine therapeutic efficacy and disease progression [6]. Functional imaging tools, such as F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET), have been considered for the assessment of responses [7]. Application of this technique is quite limited due to the high cost. The key to treatment success is to offer patients with an accurate prognosis and to adopt the appropriate treatment strategy after diagnosis
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