Chest
Volume 87, Issue 1, January 1985, Pages 39-43
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Serum Neuron-Specific Enolase: A Marker for Disease Extent and Response to Therapy for Small-Cell Lung Cancer

https://doi.org/10.1378/chest.87.1.39Get rights and content

Serum neuron-specific enolase (S-NSE) levels in 43 newly diagnosed untreated patients with small-cell lung cancer (SCLC) were compared with levels in 35 adult controls, 14 patients with non-small cell lung cancer (N-SCLC), and nine patients with noncancerous lung disease (N-CLD). The S-NSE level was raised (≥16 ng/ml) in 28 of 43 patients with SCLC, six of 16 patients with limited stage SCLC, and 22 of 27 of those with extensive stage SCLC. Extensive stage patients with SCLC had a significantly higher mean S-NSE level (50 ng/ml) than did limited stage patients with SCLC (16 ng/ml). Mean S-NSE levels in patients with N-SCLC and in patients with N-CLD were respectively 11 and 7 ng/ml. Serial measurements performed on 19 patients between the three-day-courses of chemotherapy showed an excellent correlation between S-NSE and clinical evolution. In addition, S-NSE was measured during the first three-day course of chemotherapy in 13 other patients; among them, seven had S-NSE levels ≥100 ng/ml (mean: 490 ng/ml); these seven patients were responders; the remaining six had S-NSE levels < 100 ng/ml (mean 28 ng/ml): among them, only two were responders. Such S-NSE measurements during the first cytostatic course seem to reflect the importance of tumor burden and may be valuable as early indicators of the response rate to chemotherapy.

Section snippets

Subjects

Serum samples were obtained from 56 patients with histologically confirmed SCLC undergoing protocol staging procedures including physical examination; chest roentgenogram; fiberoptic bronchoscopy (with bronchial biopsy); radionuclide scan of bones; liver echography; brain CT scan; and bone-marrow biopsy. Biopsy specimens of enlarged lymph nodes, subcutaneous nodules, and pleural effusions were taken when clinically indicated. Forty-three patients with SCLC were staged as having limited disease

RESULTS

Mean S-NSE level in controls was 6 ± 5 [SE] ng/ml (range 1 to 22 ng/ml, median 4 ng/ml). Levels equal to or greater than 16 ng/ml were considered raised since this value is almost 2 SD above the mean.

DISCUSSION

Raised S-NSE levels were found in 65.1 percent of all SCLC patients at diagnosis; this percentage is similar to those already reported by Carney et alu (69 percent) and by Ariyoshi et al12 (65 percent), although these authors defined “raised” S-NSE values respectively above 12 ng/ml and above 7.5 ng/ml. We found raised S-NSE levels in 37.5 percent of patients with limited stage disease and in 78.6 percent of patients with extensive stage disease: percentages found by Carney et al11 for these

ACKNOWLEDGMENT

The authors are grateful to Mrs. J. C. Michalon for her secretarial assistance and to Biomerieux Company (Laboratory of Dr. B. M and rand) for its participation in the antibody production. They wish to acknowledge Mrs. Clarissa Henry and Dr. J. C. Ansquer (Servier Laboratories) for preparation of the manuscript ana Dr. T. Bârzu (Institut Pasteur, Paris) for contributing insights during the course of this work.

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