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

Abstract

Background: Increased serum NSE levels were found in a substantial proportion (30%-69%) of patients with NSCLC, but little is known about the clinical properties of neuron specific enolase (NSE). Objective: We aimed to access the level of serum NSE to predict the prognosis and treatment response in advanced or metastatic non-neuroendocrine non-small cell lung cancer. Methods: We retrospectively analyzed 363 patients with advanced and metastatic NSCLC (without neuroendocrine immunohistochemistry stain and brain metastasis) between January 2011 and October 2016. The serum NSE level was measured before initiation of treatment. Results: According to the X-tile program, the optimum cut-off value for NSE level was 26.1 ng/ml. Patients with elevated NSE level (≥26.1 ng/ml) showed significantly shorter progression-free survival (PFS) (median PFS, 4.31 months vs 9.93 months; P < 0.001) and significantly shorter overall survival (OS) (median OS, 8.13 months vs 17.11 months; P < 0.001). In subgroup analysis, patients with elevated NSE level (≥26.1 ng/ml) showed significantly shorter PFS than those with low NSE level (<26.1ng/ml) in EGFR mutations group and EGFR-wide type group (6.58 months vs 16.02 months, P = 0.0016; 3.42 months vs 7.46 months, P < 0.001, respectively). In terms of OS, the patients with elevated NSE was also significantly shorter than those with low NSE in EGFR mutations group and EGFR-wide type group (9.51 months vs 27.73 months, P < 0.001; 7.76 months vs 13.55 months, P < 0.001, respectively). Univariate and multivariate analysis demonstrated that elevated NSE level was independent prognostic factors for short PFS (hazard ratio [HR] = 2.40 (1.71-3.38), P < 0.001; HR = 1.81 (1.28-2.56), P = 0.001, respectively) and OS (HR, 2.40 (1.71-3.37), P < 0.001; HR, 1.76 (1.24-2.50), P = 0.002, respectively). Conclusion: The survival of NSCLC with elevated serum NSE level was shorter than that of NSCLC with low NSE level. Serum NSE level is a predictor of treatment and independent prognostic factor.

Postoperative venous thromboembolism after surgery for stage IA non‐small‐cell lung cancer: A single‐center, prospective cohort study

“…Tumor necrosis factor (TNF) in tumor tissue plays an important role in the occurrence of VTE, and NSE levels may have predictive value for the staging and prognosis of NSCLC 22,23 . In this study, a significant difference in CEA was noted between the VTE group and the non‐VTE group, which may be related to the larger pathological diameter and later staging of patients in the VTE group.…”

Metabolic biomarkers in cancer

“…The choice of adequate treatment is a major challenge due to the very heterogeneous nature of lung cancer, and its prognosis within the same stage of development. In spite of innovations in early detection and conventional treatments, around 57 percent of patients are identified at a developed phase with a bad prognosis, and with only a 5-year survival rate of 10-15 percent overall (72). In addition, the failure of treatment is mostly because the disease has already achieved metastasis.…”