Elevated Neuron-specific Enolase Research Articles

Concomitant monitoring of serum neuron-specific enolase and creatine kinase BB in small cell lung cancer.

Serum neuron-specific enolase (NSE) and serum creatine kinase isoenzyme BB (CK-BB) were measured in 43 small cell lung cancer (SCLC) patients. The overall sensitivity of NSE (greater than 12.5 ng/ml) was 65%; in limited disease (LD) 48% and in extensive disease (ED) 100%. CK-BB was detected in 14 patients (32%); the sensitivity was 17% in LD and 64% in ED. During treatment NSE declined or stabilized to normal level in LD together with objective response in 75% (21/28), and rose again with progression in 28% (6/21). CK-BB fell to normal in all 5 patients with LD, in 3 of them with objective response. In ED elevated NSE and CK-BB declined to normal with objective response in 73% (8/11) and in 25% (2/8) of the evaluable patients respectively. We conclude that serum NSE is a potential marker for staging and response monitoring in SCLC, but that CK-BB gives additional information of limited value.

Neuron-specific enolase in the diagnosis of small-cell lung cancer with pleural effusion: A negative report : Pettersson T, Klockars M, Froseth B. Fourth Department of Medicine, Helsinki University Central Hospital, SF-00170 Helsinki. Eur Respir J 1988;1:698–700

We measured the concentration of neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA) in the serum and pleural fluid of 53 patients with pleural effusions, including seven patients with small-cell lung cancer (SCLC). High levels (above 12.5 micrograms.l-1) of NSE in pleural fluid were observed in five patients with SCLC (sensitivity 71%). However, pleural fluid NSE levels were also increased in five patients with other types of cancer and in four patients with non-malignant inflammatory diseases (specificity 80%). We conclude that although SCLC with pleural effusion can be associated with elevated pleural fluid NSE activity, this increase in enzyme levels is not specific for malignancy.

原発性肺癌患者における各種腫瘍マーカーの臨床的検討

In this study, the author has evaluated the diagnostic versatility of the neuron specific enolase (NSE), carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and serum antigens (KA 32, KA 93) which are detected by anti-human lung carcinoma monoclonal antibodies (KM 32, KM 93) in patients before initiating any treatment. The positive rates of the serum NSE, CEA, TPA, KA 32 and KA 93 in all patients suffering from lung carcinoma were 31.4% (32/102), 52.8% (56/106), 63.3% (62/98), 52% (13/25) and 20% (24/120) respectively. Serum NSE was positive in 80.8% (21/26) of patients suffering from small cell type lung carcinoma (SCLC) and the mean value (32.7 +/- 25.4 ng/ml) was significantly higher than those of other varieties of lung carcinoma. The positive rate of serum CEA in adenocarcinoma (70.2%) was significantly higher than those of squamous cell carcinoma (22.2%). There was no significant statistical difference in positive rates of TPA in various histological types of lung carcinoma. The NSE and CEA were 44.0% (22/50) and 70.6% (36/51) in the stage IV disease and they appeared to reflect the progress and extent of the disease. The TPA tended to show a positive rate even at the initial stage of the disease, but, it was noteworthy that this disclosed a relatively high false positive rate of 54.2% (13/24). Moreover, determination of the serum NSE was performed chronologically. A lowered serum NSE value was confirmed in all cases which responded to the therapeutic attempts and unchanged values or even elevated values were noted in cases which showed no favourable response or rapid progression of the disease. It was also noteworthy that the serum NSE elevation was found 2-6 weeks prior to the clinical confirmation of the recurrence of the tumor in three patients suffering from SCLC. Based on these observations, it is suggested that the serum NSE may serve as a versatile tumor marker in monitoring the stage of disease, effectiveness of the therapeutic attempts and prediction of the possibility of the recurrence in SCLC. However, in view of the fact that some of the cases that obviously demonstrated clinical evidence of tumor recurrence failed to show elevation of the NSE, caution should be exercised in evaluating the alteration of the positive rates. The monoclonal antibody that works against human lung squamous cell carcinoma (KM 32) and antibody that works against human lung adenocarcinoma (KM 93) were isolated and purified.(ABSTRACT TRUNCATED AT 400 WORDS)

The value of tumour markers in lung cancer.

The pre-treatment serum levels of neuron-specific enolase (NSE), phosphohexose isomerase (PHI) and circulating immune complexes (CC) as tumour markers were compared to measurements of standard haematology and biochemical indices in 73 patients with lung cancer, as an aid to differentiation of tumour type, estimating disease extent, predicting response to therapy and prognosis. Elevated NSE greater than or equal to 12.5 ng ml-1, PHI greater than or equal to 55 mgl-1 levels were observed in 55% of cases for NSE, 90% for PHI and 49% for CC. NSE was significantly elevated in 61% (25/41) of patients with SCLC (P less than 0.005) compared to 41% (13/32) with NSCLC. CC levels were significantly raised in 72% (23/32) of patients with NSCLC (P less than 0.05) compared to 32% with SCLC. The levels of NSE and PHI were not related to tumour stage but CC was significantly raised in limited compared to extensive disease in SCLC (P less than 0.05). Serum albumin was significantly lower in NSCLC compared to SCLC, and median values of alkaline phosphatase, gamma-glutamyltranspeptidase and aminoaspartate transferase were significantly higher in patients with extensive disease. The pre-treatment serum values of NSE, PHI, and CC did not predict the response to therapy or prognosis in the 73 patients with lung cancer. The most important prognostic factor was the number of abnormal routine laboratory parameters (greater than 4) in this group of patients.

Neuron-specific enolase in the diagnosis of small-cell lung cancer with pleural effusion: a negative report

We measured the concentration of neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA) in the serum and pleural fluid of 53 patients with pleural effusions, including seven patients with small-cell lung cancer (SCLC). High levels (above 12.5 micrograms.l-1) of NSE in pleural fluid were observed in five patients with SCLC (sensitivity 71%). However, pleural fluid NSE levels were also increased in five patients with other types of cancer and in four patients with non-malignant inflammatory diseases (specificity 80%). We conclude that although SCLC with pleural effusion can be associated with elevated pleural fluid NSE activity, this increase in enzyme levels is not specific for malignancy.

Early detection of response in small cell bronchogenic carcinoma by changes in serum concentrations of creatine kinase, neuron specific enolase, calcitonin, ACTH, serotonin and gastrin releasing peptide

Creatine kinase (CK-BB), neuron specific enolase (NSE), ACTH, calcitonin, serotonin and gastrin releasing peptide (GRP) were measured in serum or plasma before and immediately after initiation of treatment in patients with small cell lung cancer (SCC). Pretherapeutic elevated concentrations of CK-BB were found in 82% of extensive disease patients and in 50% of patients with local disease. NSE was raised in 72% with extensive disease versus 14% of patients with local disease. Calcitonin and ACTH were raised in 27% and 28%, respectively, in all patients without significant difference between extensive and local disease patients. Serotonin was generally overall elevated in 10% and GRP in 7% but elevations were seen only in patients with extensive disease. Out of the four most frequently elevated substances at least one marker was elevated in 80% of all the patients, including 91% in extensive stage patients and 71% in limited stage patients. Frequent initial monitoring of the substances showed an increase in the concentrations of pretherapeutic elevated CK-BB and NSE on day 1 or 2 followed by a sharp decrease within 1 week. These changes were correlated to objective clinical response determined within 4–8 weeks. The results indicate that serum CK-BB and NSE are potential markers for SCC at the time of diagnosis and that changes in the concentrations during the first course of cytostatic therapy are promising as biochemical tests for early detection of response to chemotherapy.

Serum neuron-specific enolase. A marker for response to therapy in seminoma

Neuron-specific enolase (NSE) was evaluated as a serum marker in 105 patients with testicular cancer and compared with the established tumor markers alphafetoprotein (AFP) and human chorionic gonadotropin (HCG). Increased serum NSE activity was measured in eight of 11 (73%) patients with metastatic seminoma. Serum NSE concentrations fell to within the normal range following chemotherapy. Localization of NSE in seminoma cells was demonstrated immunohistochemically. Only six of 40 (15%) patients with metastatic nonseminomatous germ cell tumors showed elevated serum NSE levels. AFP and HCG were both positive in 70% of patients in this group, and NSE determination gave no additional information. Serum NSE concentrations were normal in 53 of 54 testicular cancer patients after orchiectomy and there was no evidence of metastatic disease; only one had borderline NSE levels, indicating the specificity of serum NSE determination. NSE is a new marker of seminoma and its measurement may be of clinical value in monitoring chemotherapy in patients with metastatic seminoma.

Biological and Clinical Implication of Neuron-Specific Enolase and Creatine Kinase BB in Small Cell Lung Cancer

The specificity of neuron-specific enolase (NSE) and creatine kinase BB (CK-BB) for small cell lung cancer (SCLC) was determined by biological and immunohistochemical procedures in lung cancer tissues and cultured cell lines. Average values of extractable NSE and CK-BB of SCLC tissues were significantly higher than those of non-SCLC and normal lung tissues. A large amount of NSE and CK-BB was demonstrated in SCLC cell lines. Immunohistochemical examination showed positive staining for NSE and CK-BB in most cases of SCLC and in a few cases of non-SCLC. From these data NSE and CK-BB should be considered to be highly specific for SCLC. In a clinical study serum values exceeding 10 ng/ml for NSE and 1.5 ng/ml for CK-BB were set as positive for the enzymes. Positive rates in SCLC were 71.4% for NSE and 65.3% for CK-BB, which were significantly higher than those in non-SCLC. All positive cases were in an advanced stage. Consecutive daily NSE determinations during induction chemotherapy showed transient elevation immediately after the initiation of drug administration (tumor lysis syndrome), followed by a decline to normal range in responders. This phenomenon seems to indicate tumor sensitivity to cytotoxic drugs. NSE positive non-SCLC was as sensitive to cytotoxic drugs as SCLC. These findings indicate that lung cancer with elevated serum NSE and CK-BB levels at diagnosis should be strongly suspected of being SCLC in the advanced stage.

Serum neuron-specific enolase: A serum marker for nonfunctioning pancreatic islet cell carcinoma

The isoenzyme, neuron-specific enolase (NSE) was evaluated as a serum marker for nonfunctioning pancreatic islet cell carcinoma. Serum NSE was measured by radioimmunoassay in 6 patients with islet cell cancer and in 22 healthy adults. Mean serum NSE in control subjects was 5 ng/ml (range 3.2 to 8.4 ng/ml). Three of six patients had clearly elevated serum NSE with values that ranged from 22 to 44 ng/ml. One patient had an equivocally elevated serum NSE of 9.2 ng/ml while receiving chemotherapy. When relapse occurred, the NSE level increased to 44 ng/ml. One of two patients with normal serum NSE had undergone radical pancreatectomy and had no evidence of disease when studied. Elevated serum NSE returned to normal limits after removal of all gross tumor in the only patient from whom a preoperative measurement was obtained. Results of this preliminary study suggest that serum NSE levels can aid in the diagnosis and monitoring of the course of nonfunctioning islet cell carcinoma.