Measurement of Serum Neuron-Specific Enolase in Neuroblastoma: Is There a Clinical Role?

Abstract

BACKGROUND The measurement of neuron-specific enolase (NSE) in serum is frequently requested for diagnosis, risk stratification, and treatment monitoring of neuroblastoma (NB) in the pediatric population. However, authoritative clinical practice guidelines advise about the poor diagnostic performance of NSE. Content We critically appraised the available literature evaluating the diagnostic and prognostic value of NSE in the management of NB, paying special attention to the definition of appropriate threshold levels. In addition, we discuss the interfering conditions causing artifactual increases of NSE concentrations in serum and potentially influencing the clinical evaluation of patients with suspected NB. Summary No definitive evidence supports the use of serum NSE for diagnosis and monitoring of NB. The risk of obtaining false-positive NSE results associated with confounders (e.g., sample hemolysis) and other pathophysiologic conditions (e.g., inflammation) is remarkable and hampers the diagnostic value of this test. NSE may be helpful to define the risk of death of patients with NB, mainly in the advanced stages of disease. However, further studies validating currently marketed immunoassays and defining threshold values useful for this scope are warranted.

Highly Efficient PTCA/Co3O4/CuO/S2O82– Ternary Electrochemiluminescence System Combined with a Portable Chip for Bioanalysis

“…As a macromolecular protein, its molecular weight is 78 kD . NSE is overexpressed in small-cell lung cancer (SCLC), resulting in significantly elevated serum NSE (the normal value is less than 15 ng/mL). , Therefore, NSE is one of the preferred markers for SCLC clinical diagnosis. In addition, because the serum NSE level in SCLC is higher than that in non-small-cell lung cancer (NSCLC), it is also used for the differential diagnosis of SCLC and NSCLC .…”

Factors of Recurrence After Complete Response in Children with Neuroblastoma: A 16-Year Retrospective Study of 179 Cases

“…In our study, although children with serum NSE level ≥100 ng/mL had significantly higher recurrence rates than those with serum NSE level <100 ng/mL, serum NSE level at initial diagnosis was not an independent risk factor for post-remission recurrence in neuroblastoma. It is known that the sensitivity and specificity of NSE in the diagnosis of neuroblastoma are limited, 15 and that the monitoring of tumor biomarkers alone cannot reliably predict survival outcomes, including recurrence; however, this parameter could still be useful for the clinical prediction of outcome in children with neuroblastoma if a true relationship between serum NSE and recurrence is proven.…”

“…In terms of the serum NSE, the cohort was divided into groups with a level ≥100 ng/mL and <100 ng/mL. [13][14][15] Serum LDH level was dichotomized by 1400 U/L with reference to a recent prognosis study by the International Neuroblastoma Risk Group (INRG). 16 In some cases, because of the inability to accurately distinguish between retroperitoneal and adrenal space occupation by abdominal ultrasound or CT, they were combined into one category in primary sites.…”

Brain injury in extracorporeal cardiopulmonary resuscitation: translational to clinical research

“…[102]. In patients treated with ECPR, higher NSE has been shown to correlate with increased mortality and ABI; however, hemolysis is common in ECMO and may result in false positives in NSE measurement [112,113]. In patients with ABI associated with ECMO treatment, S100B was found to be significantly elevated, and in a separate case series of infants, it was significantly elevated 72 hours before ICH [114,115].…”