Abstract
Background: Increased serum neuron-specific enolase (NSE) level was found in a substantial proportion (30–69%) of patients with non-small-cell lung cancer (NSCLC), but little was known about the clinical properties of NSE in NSCLC.Objective: We aimed to assess the level of serum NSE to predict prognosis and treatment response in patients with advanced or metastatic non-neuroendocrine NSCLC.Methods: We retrospectively analyzed 363 patients with advanced and metastatic NSCLC between January 2011 and October 2016. The serum NSE level was measured before initiation of treatment.Results: Patients with high NSE level (≥26.1 ng/ml) showed significantly shorter progression-free survival (PFS) (5.69 vs 8.09 months; P=0.02) and significantly shorter overall survival (OS) than patients with low NSE level (11.41 vs 24.31 months; P=0.01).NSE level was an independent prognostic factor for short PFS (univariate analysis, hazard ratio [HR] = 2.40 (1.71–3.38), P<0.001; multivariate analysis, [HR] = 1.81 (1.28–2.56), P=0.001) and OS (univariate analysis, [HR] = 2.40 (1.71–3.37), P<0.001; multivariate analysis, [HR] = 1.76 (1.24–2.50), P=0.002).Conclusion: The survival of NSCLC patients with high serum NSE level was shorter than that of NSCLC patients with low serum NSE levels. Serum NSE level was a predictor of treatment response and an independent prognostic factor.
Highlights
Increased serum neuron-specific enolase (NSE) level was found in a substantial proportion (30–69%) of patients with non-small-cell lung cancer (NSCLC), but little was known about the clinical properties of NSE in NSCLC
Lung cancer has been divided into two main histological types: small cell lung cancer (SCLC) accounts for 15–25% of all lung cancer cases, and non-small-cell lung cancer (NSCLC) accounts for the remaining 75–85% [2], the latter is mainly subdivided into adenocarcinoma, squamous cell carcinoma (SCC), and other subtypes, including sarcomatoid carcinoma and neuroendocrine large cell carcinoma, are uncommon variants [3]
Eighty-seven patients were with EGFR mutations, and 104 adenocarcinomas were EGFR-wildtype or unknown
Summary
Increased serum neuron-specific enolase (NSE) level was found in a substantial proportion (30–69%) of patients with non-small-cell lung cancer (NSCLC), but little was known about the clinical properties of NSE in NSCLC. Objective: We aimed to assess the level of serum NSE to predict prognosis and treatment response in patients with advanced or metastatic non-neuroendocrine NSCLC. Serum NSE level was a predictor of treatment response and an independent prognostic factor. Serum biomarkers provide valuable information about the diagnosis and prognosis of a wide variety of malignant tumors, and the best known and most widely studied tumor markers of lung cancer are carcinoembryonic antigen (CEA), SCC antigen, cytokeratin-19 fragments (Cyfra21-1) and neuron-specific enolase (NSE) [5,6]. Serum NSE has been established as a clinically useful marker for staging, monitoring treatment and predicting relapse of SCLC [7].
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