Abstract
Pretreatment serum levels of neurone specific enolase (NSE) were measured in patients with small cell lung cancer (SCLC). Median values were significantly higher in patients with extensive compared with limited stage disease (48 ng ml-1 v. 17 ng ml-1: P less than 0.001). Serial NSE levels paralleled the clinical response to treatment. In 37 patients with limited SCLC, receiving identical chemotherapy, the pretreatment NSE level was of prognostic significance: with an approximate reduction in median survival of 10% for each 5 ng ml-1 incremental rise in NSE (P = 0.004).
Highlights
At the time of diagnosis, serum samples from patients with small cell lung cancer (SCLC) were stored at - 20°C; overtly haemolysed samples were discarded as haemolysis may result in falsely elevated neurone specific enolase (NSE) levels (Esscher et al, 1985)
Limited stage SCLC was defined according to the criteria of the Veterans Administration Lung Cancer Study Group (Zelen, 1973) as tumour confined to one hemithorax, with or without ipsilateral mediastinal or supraclavicular node involvement
As several multivariate analyses have shown that the prognosis in SCLC is more closely related to a few biochemical parameters and pertormance status, than disease extent, these prognostic groups based on albumin, sodium, alkaline phosphatase and alanine transaminase have been included for patients in the survival analyses
Summary
At the time of diagnosis, serum samples from patients with SCLC were stored at - 20°C; overtly haemolysed samples were discarded as haemolysis may result in falsely elevated NSE levels (Esscher et al, 1985). Staging of SCLC was based on clinical examination, chest radiology, liver ultrasound, transaminase and alkaline phosphatase levels, with other investigations (skeletal radiology, bone or brain scans) undertaken if clinically indicated. Limited stage SCLC was defined according to the criteria of the Veterans Administration Lung Cancer Study Group (Zelen, 1973) as tumour confined to one hemithorax, with or without ipsilateral mediastinal or supraclavicular node involvement. As several multivariate analyses have shown that the prognosis in SCLC is more closely related to a few biochemical parameters and pertormance status, than disease extent, these prognostic groups based on albumin, sodium, alkaline phosphatase and alanine transaminase have been included for patients in the survival analyses
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