High Neuron-specific Enolase Levels Research Articles

Abstract 110: Brain Injury Biomarkers Are Associated With Poor Neurological Outcomes Within 24 Hours After Refractory VT/VF Cardiac Arrest Requiring Extracorporeal Cardiopulmonary Resuscitation

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging method that improve survival after refractory VF/VT cardiac arrest. Neuron-specific enolase (NSE) and S-100B are used to predict neurological outcome; however, it is unclear the reliability and earliest time point during ECPR. Methods: Single-center, retrospective cohort study included OHCA patients who underwent ECPR at the University of Minnesota between December 2015 and January 2023. NSE and S100B levels were obtained at admission, at 12 and 24h after ROSC in a total of 361 unconscious patients. The primary outcome was poor neurological outcome (defined as CPC 3-5) at hospital discharge. We evaluated the optimal cut-off levels for NSE and S100B by maximizing the Youden index and ROC analyses for poor clinical results. Finally, NSE and S100B at 12h and 24h were added to a multivariable logistic model (age, sex, bystander and witnessed). Results: Of 361 patients, 170 survived to hospital admission. Of these 85% (145/170) survived neurologically favorable. Mean (SD) NSE (ng/mL) values were significantly higher in the CPC 3-5 group at every time point, 52.3 (53) vs 21.1 (12) on admission; 92.8 (92) vs 20 (10) after 12h; 107.1(94.4) vs 21.5 (12.9) after 24h; p<0.01 at all time points. Again, mean (SD) S100B (ng/L) values were significantly higher in the CPC 3-5 group at every time point 3912 (990) vs 986 (920) on admission; 3975 (4972) vs 272.2 (209) after 12h; 4454 (7300) vs 192 (239) after 24h; p<0.01 at all time points. At 24h, NSE and S100B significantly predicted poor neurological outcome with AUC 0.92; 95%CI:0.87-0.95 (optimal NSE cut-off value of 47) and 0.91; 95%CI: 0.87-0.95 (optimal cut-off S100B value of 354), respectively. High concentrations of both biomarkers at 24h (NSE: odds ratio [OR] 2.4 per 1 ng/mL, p<0.001; S100B: odds ratio [OR] 1.1 per 1 ng/L, p<0.05) were independent for poor outcome in a multivariate analysis. Additionally, the combination of both markers (AUC, 0.94; 95%CI: 0.91-0.97) showed significantly higher predictive performance than when using them individually. Conclusions: By using serial measurements, high NSE and S100B levels may help early predict progression to poor neurological outcome in OHCA survivors requiring ECPR in the first 24h after ROSC.

The relationship between neuron-specific enolase, high sensitivity C reactive protein, and diabetic peripheral neuropathy in Chinese patients with type 2 diabetes: A prospective nested case–control analysis

BackgroundDiabetic peripheral neuropathy (DPN) involves a very complex pathogenesis, and there is no neuro-specific marker for risk prediction. Neuron-specific enolase (NSE), a key enzyme in glycolysis, has a broad spectrum neurotrophic and neuroprotective effect on neurons, and also cause injury and inflammatory response of peripheral nerves. The relationship between neuron-specific enolase, highly sensitive c-reactive protein (hsCRP), and diabetic peripheral neuropathy remains unclear. We aimed to investigate whether elevated serum NSE and hsCRP levels increased the risk of DPN in patients with type 2 diabetes.Materials and methodsIn this prospective nested case–control study, a total of 1072 eligible subjects with type 2 diabetes constituted the follow-up cohort. Demographic data and parameters including serum NSE and hsCRP were collected at baseline. Two neuropathy screening scales (MNSI and MDNS) were used to assess DPN during follow-up period. Nerve conduction studies were performed at the end of follow-up. Conditional logistic regression was used to inspect the risk factors of the incidence of DPN.ResultsDuring an average follow-up period of 5.1 years, 176 subjects developed DPN. Serum NSE and hsCRP levels at baseline were significantly higher in DPN group than in matched non-DPN groups (p < 0.001). NSE was positively correlated with age and hsCRP (p < 0.001). The amplitude of sensory nerve action potential and compound muscle action potential of the lower extremity nerves were significantly decreased in the high tertile of NSE. After adjustment for matching and confusing factor, conditional logistic regression showed the risk of DPN in the high tertile of NSE level was still 3.176 times higher than that in the low tertile of NSE level (p < 0.001).ConclusionElevated serum NSE levels predicted the high incidence of DPN in Chinese patients with type 2 diabetes for an average of 5.1 years, which may be associated with increased neuroinflammatory response caused by high NSE levels, but further studies are needed.

The Relationship Between Neuron-Specific Enolase and Clinical Outcomes in Patients Undergoing Mechanical Thrombectomy.

Neuron-specific enolase (NSE) is considered a biomarker for the severity of nervous system diseases. We sought to explore whether serum NSE concentration in ischemic stroke patients undergoing mechanical thrombectomy (MT) is related to 3-month functional outcome and symptomatic intracranial hemorrhage (sICH). We retrospectively collected the data of acute ischemic stroke patients with anterior circulation infarction receiving MT within 6 h in our stroke center. Favorable outcome and poor outcome at 3 months were defined as modified Rankin Scale (mRS) score 0-2 and 3-6, respectively. sICH was defined according to the Heidelberg bleeding classification. We used multivariate logistic regression model and receiver operating characteristic curves to investigate the correlation between NSE and clinical outcomes. Among the 426 patients enrolled, 40 (9.4%) patients developed sICH. Three-month favorable outcome in 160 (37.6%) and poor outcome in 266 (62.4%) patients were observed. Serum NSE levels was significantly correlated with 3-month mRS score (R = 0.473, P < 0.001). A cutoff value of 15.29 and 23.12 ng/mL for serum NSE was detected in discriminating 3-month poor outcome (area under the curve, 0.724) and sICH (area under the curve, 0.716), respectively. Multivariate analysis showed that high serum NSE levels were independently associated with 3-month poor outcome (odds ratio [OR] 5.049, 95% confidence interval [CI] 2.933-8.689, P<0.001) and sICH (OR 5.111, 95% CI 2.210-11.820, P < 0.001). Our study demonstrated that high serum NSE levels after receiving MT were independently associated with 3-month poor outcome and sICH in acute ischemic stroke patients. Serum NSE levels could be a good predictor of clinical outcomes for patients receiving MT.

Biomarkers for prediction of neurological complications after acute Stanford type A aortic dissection: A systematic review and meta-analysis.

The predictive value of biomarkers such as neuron specific enolase (NSE), S100B, neurofilament (NFL), interleukin-6 (IL-6), coagulation factor R, and D-Dimer (DD) after acute Stanford A type aortic dissection (AAAD) with neurological complications has recently gained much attention from the research community. However, results from these studies are conflicting. This meta-analysis is conducted to assess the relationship between the biomarkers and the risk of neurological complications after AAAD. Two reviewers performed a systematic literature search across eight databases (CNKI, Wan Fang, VIP, CBM, PubMed, Web of Science, Cochrane Library, and EMBASE). The studies regarding biomarkers in AAAD patients published up to February 2022 were included. These studies were subjected to rigorous scrutiny and data extraction to determine the weighted mean difference (WMD) and the 95% confidence interval (CI), which were analyzed using the RevMan 5.4 and Stata software 14.0. A total of 12 studies including 360 cases with neurological complications and 766 controls were incorporated into our meta-analysis. WMD analysis showed that there was a higher NSE levels in AAAD patients with postoperative neurological complications compared with controls (WMD = 0.640, 95% CI: 0.205 ~ 1.075, P = 0.004 < 0.005), and the level of S100B was related to the 6 h and 24 h postoperative neurological complications (6 h: WMD = 0.64, 95% CI: 0.27 ~ 1.02, P = 0.0007 < 0.001; 24 h: WMD = 0.281, 95% CI: 0.211 ~ 0.351, P < 0.001). Moreover, S100B levels at 6 hours after operation were significantly higher than that at 24 hours (WMD = 0.260, 95% CI: 0.166 ~ 0.354, P < 0.001). NSE and S100B are both candidate biomarkers to predict postoperative neurological complications in patients with AAAD. Other markers are also valuable when used in conjunction with clinical judgement. The findings accentuate the necessity of further research to establish standardized values for these biomarkers in predicting neurological complications.

A retrospective study of the correlation between herpes zoster neuralgia and the serum neuron-specific enolase level in the largest dermatological hospital in Zhejiang province, China.

We studied the changes and clinical significance of the serum neuron-specific enolase (NSE) level in peripheral blood of patients with post-herpetic neuralgia (PHN).Material and methodsPatients with PHN were divided into a mild PHN group and a severe PHN group according to their scores on a 100-point Likert scale representing the degree of neuralgia. NSE levels in neuralgia patients and healthy volunteers were then compared by t-test. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic efficiency of NSE for PHN. The correlation between NSE level and Likert scale score after treatment was analyzed.ResultsNSE levels in PHN patients were higher than those in the healthy volunteers. Patients in the severe PHN group had higher NSE levels than those in the mild PHN group. NSE level at admission was associated with the Likert scale score recorded on the 14th day of treatment (136.1 ± 32.81 vs. 87.53 ± 16.23 pg/mL) (P < 0.05). The ROC curve of NSE levels for PHN is shown that the area was 0.8713 (95% confidence interval, 0.7861–0.9564; p < 0.0001).ConclusionsThere was a correlation between NSE and PHN, in that the NSE level positively correlated with the short-term prognosis of patients with PHN.

Hiponatremili hastalarda serum nöron spesifik enolaz düzeyleri ile beyin hasarı arasındaki ilişki

Purpose: In this study, we aimed to investigate the effects of serum neuron specific enolase on the prediction of central nervous system injury and the clinical course in patients to have hyponatremia.&#x0D; Materials and Methods: 75 adult patients with serum sodium levels less than 135 mEq/L were evaluated. The patients were grouped according to serum neuron specific enolase levels (group 1 ≤ 17.0 ng/mL and group 2 &gt; 17.0 ng/mL). The groups were compared according to demographic and laboratory data. &#x0D; Results: The incidence of hypertension, heart failure, and loss of consciousness was significantly higher in group 2 patient. High neuron specific enolase levels were related to lower serum sodium levels. The mean sodium levels were 129.5 ± 4.3 mEq/L and 126 ± 4.5 mEq/L in groups 1 and 2, respectively. Of the patients in group 2 (n = 45), 8 patients with loss of consciousness (low Glasgow Coma Scale scores) (i.e.

Clinical risk factors of carbohydrate antigen-125, cytokeratin fragment 19, and neuron-specific enolase in liver metastases from elderly lung cancer patients.

Objective: Lung cancer is a common malignant tumor characterized by challenging detection and lack of specificity in clinical manifestations. To investigate the correlation of tumor markers in the serum with liver metastasis and prognosis of lung cancer. Methods: A total of 3,046 elderly lung cancer patients were retrospectively studied between September 1999 and July 2020. Divided into liver metastasis group and non-liver metastasis group. We compared a series of serum biomarkers between the two groups of elderly patients to predict the prognosis in patients with lung cancer by fluorescence in situ hybridization (FISH), advanced flow cytometry (FCM) and multi tumor marker protein chip, including tumor markers in the serum included alkaline phosphatase (ALP), serum calcium, hemoglobin (HB), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin fragment 19 (Cyfra21-1), carbohydrate antigen-125 (CA-125), carbohydrate antigen-153 (CA-153), carbohydrate antigen-199 (CA-199), and free prostate specific antigen (free PSA). We used binary logistic regression analysis to determine risk factors, and used receiver operating curve (ROC) analysis to evaluate the diagnostic value of liver metastases in elderly patients with lung cancer. Results: The proportion of lung cancer in the liver metastasis group was higher than that observed in the non-liver metastases group. The expression levels of CA-125, Cyfra21-1, and NSE in the liver metastasis group of lung cancer were significantly higher than those reported in the non-liver metastases group (p < 0.05). ROC curve analysis shows that the area under the curve of CA-125, Cyfra21-1, and NSE are 0.614, 0.616 and 0.608, respectively. The sensitivity and specificity of CA-125 were 45.70% and 76.20%, the sensitivity and specificity of Cyfra21-1 were 60.10% and 57.10%, and the sensitivity and specificity of NSE were 44.10% and 75.00%, respectively. Conclusion: High levels of CA-125, Cyfra21-1, and NSE in the serum may be associated with liver metastasis in elderly patients with lung cancer. CA-125 and NSE are factors influencing the prognosis of elderly patients with liver metastasis of lung cancer.

A panel of serum biomarkers, including damage, apoptosis and neurotrophic markers, for the assessment of prognosis of the course of ischemic stroke

Identification of the relationship between clinical and neuroimaging data and the content of serum biomarkers (damage marker - neuron-specific enolase (NSE), apoptosis - p53 protein and neuroplasticity - brain-derived neurotrophic factor (BDNF)) in acute, early and late recovery periods of ischemic stroke. Eighty patients in the acute, early and late recovery periods of ischemic stroke, aged from 49 to 75 years, were examined. The comparison group included 20 patients with chronic cerebral ischemia, comparable to the study group. A clinical assessment was carried out on the following scales: The National Institutes of Health Stroke Scale (NIHSS), the European Stroke Scale (ESS), the modified Rankin scale, the Bartel Index and SS-QOL. In the acute, early and late recovery periods of ischemic stroke, the dynamics of biomarker levels (NSE, p53 protein, BDNF) in blood serum and brain MRI in T1, T2, FLAIR, DWI modes were quantified. In patients with a favorable course in the acute period of stroke, low values of the NSE level and a trend towards increased levels of serum BDNF by the 10th day of the disease were noted. For the first time, it was found that high NSE and stable BDNF levels or a tendency to their decrease were observed in the acute period in patients with an unfavorable course of ischemic stroke. In the early recovery period of ischemic stroke, a strong correlation was established between the degree of independence and disability of patients, and the levels of serum NSE and BDNF. A significant inverse correlation was proved between the severity of neurological deficit, assessed on the ESS, in the late recovery period of ischemic stroke (12 months) and the level of BDNF in blood serum (r=-0.464). The selected complex of biochemical methods allowed us to assess the severity of damage, the activity of apoptotic and compensatory neurotrophic capabilities of brain tissue in ischemic stroke, as well as their relationship with clinical and neuroimaging data. We have shown the prognostic significance of the selected markers, which will allow, with an integrated approach, more accurate prediction of the further course and outcome of stroke.

Role of neuron-specific enolase, glial fibrillar acidic protein and NR2-antibodies in early diagnostic of ischemic stroke

Background. Application of a biomarker panel during the acute period of the ischemic stroke (IS) can contribute to a more accurate and prompter diagnostics and verification of the optimal approach to a patients’ management.Objective. We aimed to clarify values of neuron-specific enolase (NSE), glial fibrillar acidic protein (GFAP) and antibodies for NMDA receptor’s NR2-subunit (NR2-antibodies) in the acute period of IS, to compare with such values in patients without IS, to assess their relationship with severity of neurological deficit and short-term outcome and also to establish sensitivity and specificity of the biomarker panel.Design and methods. 63 patients with IS and 31 people (11 with chronic brain ischemia and 20 healthy individuals) as controls were included. Results. NSE and GFAP values in IS group exceeded reference values at the onset of disease, lowering significally by 10-14 day, while NR2-antibodies’ values were lower at the onset of the disease compared with controls, rising by 10-14 day. In patients with unfavourable short-term outcome higher levels of NSE, GFAP and NR2-antibodies were found. A panel of such biomarkers has higher sensitivity and specificity than each of them individually.Conclusion. Researched substances can be used in a biomarker panel for IS diagnostics, brain damage monitoring, patient’s condition evaluation and short outcome prognosing.

Neuron Specific Enolase in Children with Diabetic Ketoacidosis: Does it Correlate with Impaired Consciousness and Disease Severity?

Background: Diabetes ketoacidosis (DKA) is the leading cause of death in children with diabetes, especially when it is complicated by cerebral edema. The predictors of CNS dysfunction/injury are largely unknown. In many neurological disorders, neuron-specific enolase (NSE) is a marker of neuronal damage. Objective: This study aimed to investigate the role of serum neuron-specific enolase as a marker of neuronal damage in patients with DKA. Patients and methods: A cross-sectional study with 90 DKA patients (aged 9.58 ± 2.89 years) presenting to Pediatric Intensive Care Unit (PICU), Children Hospital Zagazig University. Patients subjected to clinical history and examination including Glasco coma scale (GCS), blood glucose, serum electrolytes, blood PH and computed tomography of the brain for children with disturbed consciousness. Blood NSE at admission (baseline point) and after 24 hours of starting treatment of DKA (2-time points). Results: There was a significant difference between NSE level on admission and NSE level 24 hours after start of treatment. Patients with low GCS scores had higher serum NSE at baseline and 2-time points than those with normal CGS (P=0.001; P=0.053). Patients with moderate and severe DKA had higher NSE at baseline and 2-time points in comparison with those with mild DKA (P=0.001; P=0.098). Conclusions: Children with moderate to severe DKA and impaired consciousness had higher serum NSE. The high levels of NSE in patients with abnormal GCS, in the absence of cerebral edema on brain imaging indicate that NSE is a reliable marker of neuronal injury.

Prognostic value of neuron-specific enolase in patients with advanced and metastatic non-neuroendocrine non-small cell lung cancer.

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.

Diagnostic Immunostaining and Tumor Markers Predict the Prognosis of Esophageal Neuroendocrine Cell Carcinoma Patients.

Esophageal neuroendocrine carcinoma (ENEC) has a poor prognosis, and predicting the prognosis by examining various markers may contribute to the determination of treatment strategies. Therefore, a multiple-institution retrospective study was performed to identify biomarkers using diagnostic immunohistochemistry and serum tumor markers that predict the prognosis of patients with ENEC. The results of immunohistochemical examination and serum tumor markers were extracted from the data of 141 ENEC patients at 39 institutions certified by the Japan Esophageal Society. The study then examined correlations between these data and prognosis or treatment effects. The ENEC patients with positively for all expression of synaptophysin (Syn), chromogranin A (CgA), and CD56 had a significantly worse prognosis than the patients with other expression patterns. Additionally, surgery and chemoradiotherapy were significantly more effective treatments than chemotherapy for the patients who were not positive for all expressions of Syn, CgA, and CD56. In terms of serum tumor markers, the patients with a high neuron-specific enolase (NSE) value had a significantly worse prognosis than the patients with a normal NSE value, and complete response (CR) cases treated with chemotherapy were significantly fewer in the high-NSE group. The results of multivariate analysis demonstrated that high NSE levels were an independent poor prognostic factor for esophageal endocrine cell carcinoma. This study showed that positivity for all expressions of Syn, CgA, and CD56, and a high NSE value were significantly worse prognostic factors for ENEC patients than other expression patterns and may be important prognostic biomarkers of ENEC.

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value.

To analyze the levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the intensive care unit (ICU), and their prognostic value. The data of 98 patients with severe craniocerebral injury combined with delirium and multiple injuries admitted to our hospital from January 2018 to May 2019 were retrospectively analyzed as the study group. The differences in serum S100B, NSE, and CypA levels in each group were compared, and the deaths of the study group during follow-up were counted. The levels of S100B, NSE, and CypA in the study group were higher than those in the control group (P<0.05). The mortality rate of the 98 patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU was 37.76%. Furthermore, the levels of S100B, NSE, and CypA in the death group were higher than those in the survival group (P<0.05). Glasgow Coma Score (GCS) score ≤5 points, Injury Severity Score (ISS) score >25 points, multiple organ dysfunction syndrome, and increased levels of S100B, NSE, and CypA were independent risk factors that affected the prognosis of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU (P<0.05). The average survival times of the high S100B level group, the high NSE level group, and the high CypA level group were shorter than those of the low-level groups (P<0.05). The levels of S100B, NSE, and CypA in serum were closely related to the prognosis of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU. They can be used as molecular markers for predicting the prognosis of patients, and may serve as potential targets for treatment.

Neuron-specific enolase as a diagnostic marker of chronic gastroduodenitis in children

Objective: to assess the nature of changes in the level of neuron-specific enolase (NSE) in children suffering from chronic gastroduodenitis, depending on the severity of the disease, gender and physical development indicators.Materials and methods. The study group included 154 children aged 8–15 years with chronic gastroduodenitis. The main group includes children with superficial gastroduodenitis (group I) and erosive gastroduodenitis (group II). The control group consisted of 56 healthy children. All children underwent an assessment of physical development. The serum NSE level was determined by enzyme-linked immunosorbent assay. It was revealed that the main parameters of the physical development of children from the control group exceeded the values of similar parameters of children of the main group. High NSE values were established in children with chronic gastroduodenitis in comparison with the control (p≤0.01). The NSE level in boys exceeded the value of the indicator in girls in the main group and in the control group. The level of NSE in girls of the main group exceeded the value of NSE in healthy girls (p≤0.05). Studying the level of NSE taking into account gender and the severity of the pathological process revealed higher rates in boys with erosive gastroduodenitis compared with the control group (p≤0.05). In the group of children with erosive gastroduodenitis, higher NSE rates were found in boys compared with girls (p&lt;0.05).Conclusions: A high level of NSE in children with erosive gastroduodenitis and revealed gender differences in NSE concentrations in blood serum indicate the possible role of this indicator in the development of severe forms of the disease and do not exclude the possible association of the effects of this enzyme with the function of sex hormones. The quantitative values of NSE for predicting the development of chronic gastroduodenitis in children are established.

High Serum Neuron-Specific Enolase Level Is Associated with Mild Cognitive Impairment in Patients with Diabetic Retinopathy.

PurposeDiabetic retinopathy (DR) can increase the risk of mild cognitive impairment (MCI), which has been confirmed by previous researches. With the frequent occurrence of MCI in patients with DR, the early detection of MCI has become a research hot-spot. The aim of this study was to investigate the relationship between neuron-specific enolase (NSE) and MCI in patients with DR.Patients and MethodsA total of 124 patients with DR, including 56 MCI patients and 68 normal cognition patients, were recruited in this cross-sectional study. The demographic and clinical data of patients were collected through questionnaires. Serum NSE was measured using electrochemiluminescence immunoassay. The Minimum Mental State Examination (MMSE) scale was used to evaluate the cognitive function of the participants.ResultsCompared with the normal cognition group, serum NSE levels and HbA1c levels in the MCI group were higher, while MMSE scores and educational level were lower (P<0.05). Serum NSE levels were significantly negatively correlated with MMSE total score, attention and calculation score, and language score (P<0.05). After adjusting for confounding factors, serum NSE still increased the MCI risk in DR patients (OR:1.606, 95CI%:1.264–2.041, P<0.001). The areas under the receiver operating characteristics (ROC) curves (AUC) of the crude model and the adjusted model were 0.75 and 0.73, respectively.ConclusionA high serum NSE level is an independent risk factor for MCI in DR patients. In addition, serum NSE is expected to be a potential biomarker in DR patients with MCI.

Could the Implantation of Dextranomer/Hyaluronic Acid Cause the Elevation of Neuron-Specific Enolase in Children Treated for Vesicoureteral Reflux?

Background: Dextranomer/hyaluronic acid copolymer (Dx/HA) has been the most widely used bulking agent for the endoscopic treatment of vesicoureteral reflux. Case presentation: Here we report on a case of an 18-month-old male who underwent endoscopic treatment with Dx/HA for persistent high-grade unilateral vesicoureteral reflux (VUR). Three months later, due to the reappearance of contralateral VUR and indicated endoscopic treatment, a second cystoscopy was performed. A submucosal, well-vascularized mass localized on the left trigone and anteromedially to the left orifice was noted. Since it differed from the other similar implants previously detected on cystoscopy, it was misdiagnosed with a bladder tumor, indicating further evaluation. Extensive laboratory and imaging studies revealed normal findings, apart from high levels of neuron-specific enolase (NSE). A hypothesis made at that point was that the elevated level of NSE is due to the implantation of the Dx/HA. To test the hypothesis, two other healthy children previously treated with a Dx/HA implant were identified and their NSE levels measured. In both cases, the levels of NSE were elevated. Conclusion: The presented cases revealed that elevated levels of NSE are most likely due to a previous implantation of Dx/HA. This observation should be taken into consideration whenever there is a tentative diagnosis of bladder tumor following the endoscopic treatment of VUR with Dx/HA in a child.

Clinical evaluation of carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 199 and neuron-specific enolase in locally advanced-stage non-small cell lung cancer patients with adjuvant chemotherapy

Background: Response markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA19-9 and neuron-specific enolase (NSE) constitute the common modulated parameters in non-small cell lung cancer (NSCLC).Objective: This study evaluated the pivotal role of biomarkers CEA, CA125, CA19-9 and NSE in the diagnosis and prognosis of NSCLC in both Stage IIIA and IIIB patients undergoing adjuvant chemotherapy.Materials and Methods: We adapted a retrospective design to review 1875 lung cancer patients' medical records from Jiangsu Province Cancer Hospital, Respiratory Department, from 2012 to 2017 who underwent surgery and were currently diagnosed with NSCLC. In total, 168 patients were eligible for final analysis. Blood samples from these patients were taken for CEA, CA125, CA19-9 and NSE analysis before and after each cycle of adjuvant chemotherapy.Results: A high level of CEA, CA125, CA19 9 and NSE was detected in 99 (58.92%), 87 (51.78%), 42 (25%) and 50 (29.76%) cases, respectively. Progression occurred in 56 of 168 patients, and their overall progression free survival (PFS) was 4–6 months. Patients with CEA level elevated and normal had a median PFS of 4 versus 8. Similarly, CA125, CA19 9 and NSE had a median PFS of 4 versus 6 (P = 0.001). In multivariable Cox regression model, treatment (2 vs. 3 drugs), metastasis (yes vs. no), CEA (≤3.5 ng/ml vs. >3.5 ng/ml) and CA125 (≤35 U/ml vs. >35 U/ml) (P = 0.01, P = 0.05, P < 0.0001 and P = 0.001, respectively) were found independent prognostic factors for PFS of NSCLC, and patients using three drug therapy showed prolonged PFS compared to those using two drug therapy (P = 0.001).Conclusions: Conclusively, we found that high pre-treatment levels CEA and CA125 correlated with poor prognosis and progression of the disease also occurred. In addition, in adjuvant chemotherapy, the use of bevacizumab with platinum-based chemotherapy showed a high efficacy in lowering tumour markers level and improved PFS.

Neuron-specific blood enolase in children with &lt;i&gt;Helicobacter pylori&lt;/i&gt;-associated chronic gastroduodenitis

The aim of the study was to assess the level of blood neuron specific enolase (NSE) in children with chronic gastroduodenitis (CGD) depending on Hеlicobacter pylori (HP), the severity of the inflammatory process, sex. The study involved 73 children with CGD. Group I– children with CGD associated with HP (HP CGD+); group II – with CGD not associated with HP (CGD, HP–). The control group (GK) – 28 healthy children. In the diagnosis of the disease, the endoscopic and morphological methods were used; the urease, microscopy, molecular biological and serological tests were performed to verify HP. The elevated levels of NSE were revealed in children groups I and II compared with GK (p &lt; 0.01, p &lt; 0.01). High levels of NSE in serum were observed in boys with CGD HP+ compared with girls with CGD HP+ (p &lt; 0.01). Similar changes related to the gender were identified in group II (p &lt; 0.01). In group I the highest values of NSE were identified with erosive gastroduodenitis (p &lt; 0.01). In group II the opposite direction of enzyme changes was revealed and depended on the severity of the disease. Тhe increase of NSE in the blood of children with CGD HP+ and HP-indicates the presence of enzyme in the mechanisms of the inflammatory process in the mucous membrane gastroduodenal area outside the continuum of HP-infection. A multidirectional character of NSE changes depending on the characteristics of lesions mucous membrane gastroduodenal zone in groups I and II does not exclude the NSE involvement into the mechanisms of formation of the severity of the disease. Higher levels of NSE in boys as in CGD, HP+ and HP – do not exclude the relations of NSE and sex hormones.

Clinical value of serum neuroglobin in evaluating hypoglycemic brain injury in neonates

To study the clinical value of serum neuroglobin in evaluating hypoglycemic brain injury in neonates. A total of 100 neonates with hypoglycemia were enrolled as subjects. According to amplitude-integrated EEG (aEEG) findings and/or clinical manifestations, they were divided into symptomatic hypoglycemic brain injury group (n=22), asymptomatic hypoglycemic brain injury group (n=37) and hypoglycemic non-brain injury group (n=41). The three groups were compared in terms of blood glucose, duration of hypoglycemia, levels of neuroglobin and neuron-specific enolase (NSE), and modified aEEG score. The correlation of neuroglobin with NSE and modified aEEG score was analyzed. The receiver operating characteristic (ROC) curve was plotted. Compared with the asymptomatic hypoglycemic brain injury and hypoglycemic non-brain injury groups, the symptomatic hypoglycemic brain injury group had significantly lower blood glucose and modified aEEG score, significantly higher neuroglobin and NSE levels, and a significantly longer duration of hypoglycemia (P<0.05). Compared with the hypoglycemic non-brain injury group, the asymptomatic hypoglycemic brain injury group had significantly lower blood glucose and modified aEEG score, significantly higher neuroglobin and NSE levels, and a significantly longer duration of hypoglycemia (P<0.05). Neuroglobin was positively correlated with NSE and duration of hypoglycemia (r=0.922 and 0.929 respectively; P<0.05) and negatively correlated with blood glucose and modified aEEG score (r=-0.849 and -0.968 respectively; P<0.05). The areas under the ROC curve of neuroglobin, NSE and modified aEEG score were 0.894, 0.890 and 0.941 respectively, and neuroglobin had a sensitivity of 80.8% and a specificity of 95.8% at the optimal cut-off value of 108 mg/L. Like NSE and modified aEEG score, serum neuroglobin can also be used as a specific indicator for the assessment of brain injury in neonates with hypoglycemia and has a certain value in clinical practice.

Neuron-Specific Enolase Is an Independent Prognostic Factor in Resected Lung Adenocarcinoma Patients with Anaplastic Lymphoma Kinase Gene Rearrangements.

BackgroundAn extensive body of research reveals the clinical value of serum tumor markers in lung cancer patients, including carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), cytokeratin-19 fragments (Cyfra21-1), and neuron-specific enolase (NSE), but little is known about the clinical properties of these serum tumor markers in anaplastic lymphoma kinase (ALK)-positive lung cancer patients.Matreial/MethodsWe retrospectively analyzed 54 patients harboring ALK rearrangements and 520 patients without ALK rearrangements, and all these patients were treated exclusively by surgery between 2011 and 2016.ResultsNSE level (P=0.007 for OS) was identified as an independent prognostic factor among patients with resected ALK-positive adenocarcinoma of the lung.ConclusionsA high level of NSE is associated with worse outcome among resected lung adenocarcinoma patients harboring ALK rearrangements.