Serum neurone‐specific enolase as an indicator of stroke volume

Cunningham, R. T.; Watt, Makayla; Winder, John; McKinstry, Steven; Lawson, J. T.; Johnston, C.F.; Hawkins, SA; Buchanan, K.D.

doi:10.1046/j.1365-2362.1996.129282.x

Cited by 70 publications

(68 citation statements)

References 19 publications

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“…Cunningham et al [4], Schaarschmidt et al [14] have also reported that increased levels of Serum NSE correlated with worse clinical outcome. According to Wunderlich et al [15] observed that serum levels of NSE would be expected to rise as long as damage due to the infarction continued and NSE was washing out of the brain tissue (Fig.…”

Section: Discussionmentioning

confidence: 97%

“…Fassbender et al [10], Cunningham et al [4], Missler et al [18] failed to demonstrate the significant correlation between NSE and neurological outcome.…”

Section: Discussionmentioning

confidence: 97%

“…The ac and cc (more common) isoforms are known as NSE because they initially were found in neurons and neuroendocrine cells. NSE is considered as specific neurobiochemical marker of brain damage after brain infarctions in humans [3,4] or in animals [5][6][7]. It is assumed that NSE, being an enzyme from the cellular cytoplasm, is released during cell destruction.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Brain Biomarker Neuron Specific Enolase (NSE) with Degree of Disability and Neurological Worsening in Cerebrovascular Stroke

Bharosay

Varma

et al. 2011

Ind J Clin Biochem

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Stroke is the third major cause of death and foremost cause of disability worldwide. Cerebrovascular stroke remains largely a clinical diagnosis. The use of biomarkers in diagnosing stroke and assessing prognosis is an emerging and rapidly evolving field. The study aimed to investigate the predictive value of neurobiochemical marker of brain damage (neuron-specific enolase [NSE]) with respect to degree of disability at the time of admission and neurological worsening in acute ischemic stroke patients. We investigated 150 patients with cerebrovascular stroke who were admitted within 72 h of onset of stroke in the Department of Neurology at SAIMS. Venous blood samples were taken after admission and NSE was analyzed by solid enzyme linked immunosorbent assay using Analyzer and microplate reader from Biored: Code 680. In all patients, the neurological status was evaluated by a standardized neurological examination and the National Institutes of Health Stroke Scale on admission and on day 7. Serum NSE concentration was found to significantly correlate with both degree of disability and neurological worsening in acute ischemic stroke cases in the present study. The maximum serum NSE level within 72 h of admission was significantly higher in patients with greater degree of disability at the time of admission. Serum NSE levels were also found to be significantly elevated in patients with bad neurological outcome. Our study showed that serum NSE has high predictive value for determining severity and early neurobehavioral outcome after acute stroke.

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Section: Discussionmentioning

confidence: 97%

“…Fassbender et al [10], Cunningham et al [4], Missler et al [18] failed to demonstrate the significant correlation between NSE and neurological outcome.…”

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Correlation of Brain Biomarker Neuron Specific Enolase (NSE) with Degree of Disability and Neurological Worsening in Cerebrovascular Stroke

Bharosay

Varma

et al. 2011

Ind J Clin Biochem

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“…One piece of evidence which can support this hypothesis is the relationship between the degree of neuronal damage and the serum NSE level following a cerebral stroke (Cunningham et al, 1991(Cunningham et al, , 1996DeGiorgio et al, 1995DeGiorgio et al, , 1999Fogel et al, 1997;Missler et al, 1997;Martens et al, 1998;Buttner et al, 1999;Schoerkhuber et al, 1999;Wunderlich et al, 1999) or other neuronal brain damage (DeGiorgio et al, 1995(DeGiorgio et al, , 1999Fogel et al, 1997;Martens et al, 1998; Buttner et al, 1999;Schoerkhuber et al, 1999). In these diseases, the serum NSE level exhibits a prognostic indication inasmuch as studies have found a close relationship between the volume of affected neuronal tissue and the serum NSE level (Cunningham et al, 1991(Cunningham et al, , 1996Missler et al, 1997;Wunderlich et al, 1999). We hypothesize that the poor outcome of patients with a high NSE level and brain metastasis is due to the severity of normal neuronal tissue damage surrounding metastases.…”

Section: Discussionmentioning

confidence: 99%

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

et al. 2001

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Patients with lung cancer frequently suffer from brain metastases at the time of presentation. This condition affects approximately 10% of non-small cell lung cancer (NSCLC) patients (Newman and Hansen, 1974;Sorensen et al, 1988). Surgery is feasible only for a small proportion of these patients. Whole brain radiotherapy has been, hitherto, the generally recommended treatment in inoperable patients. The survival of NSCLC patients with brain metastases is poor, reported to be between 3 to 6 months in patients treated with medical therapies, either radiotherapy or chemotherapy (compared to 6-10 months in other advanced NSCLC (Paesmans et al, 1995;Shepherd, 1999)). Furthermore, brain metastases at the time of presentation of lung cancer seems to be a worse prognosis (Sorensen et al, 1988) than metachronous brain metastases.New therapeutic strategies are needed to improve the outcome of these patients. The knowledge of prognostic determinants might be important in both clinical trials and routine practice (Komaki et al, 1993;Charloux et al, 1997;Paesmans et al, 1997;Merrill et al, 1999). In the former setting, prognostic co-variables must be taken into account in survival analyses; by way of illustration, in a given randomized trial, the statement that a difference in survival is related to the effects of the treatment must be supported by a proportional hazards model demonstrating that this effect does not depend on well-known prognostic determinants (Depierre et al, 1999;Furuse et al, 1999). In the second setting, a therapeutic decision might be influenced by the state of prognostic variables (Komaki et al, 1993).Here we especially take a look at the prognostic significance of 2 specific serum markers, CYFRA 21-1 and neuron-specific enolase (NSE). The prognostic value of CYFRA 21-1 (a fragment of cytokeratin subunit 19) in this disease has been suggested (Pujol et al, 1993;Wieskopf et al, 1995;Brechot et al, 1997). NSE, the γ-subunit of enolase, has been widely investigated as a marker of small cell lung cancer (SCLC;Jorgensen et al, 1989). Although only a small proportion of NSCLC presented with a high NSE level, this marker might indirectly reflect; i) a neuroendocrine component of the disease in favour of tumour heterogeneity; ii) a Summary A multi-centre retrospective study involving 4 French university institutions has been conducted in order to identify routine pretherapeutic prognostic factors of survival in patients with previously untreated non-small cell lung cancer and brain metastases at the time of presentation. A total of 231 patients were recorded regarding their clinical, radiological and biological characteristics at presentation. The accrual period was January 1991 to December 1998. Prognosis was analysed using both univariate and multivariate (Cox model) statistics. The median survival of the whole population was 28 weeks. Univariate analysis (log-rank), showed that patients affected by one of the following characteristics proved to have a shorter survival in comparison with the opposite status...

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“…Bunun nedeni beyin hücrelerinin heterojenitesinin, iskemiye toleranslarının ve beyindeki dağılım alanlarının farklılığı, iskemik kaskadın karmaşıklığı ve kan-beyin bariyerinin varlığından kaynaklanmaktadır. İnmeli hastalarda inflamatuar belirteçler, glial aktivasyon ve nöronal hücre hasarını gösteren kandaki belirteçlerle ilgili olarak çeşitli çalışmalar yapılmıştır, fakat hiçbir çalışmada bu belirteçler tek başına tanı koyma anlamında klinik olarak anlamlı bulunmamıştır (6)(7)(8)(9)(10)(11). Bu zorluğu yenmenin bir yolu olarak birçok belirtecin beraber ve ortak bir değerlendirmeye alınması ile aşılabileceği söylen-miştir (12,13).…”

Section: Introductionunclassified

The Clinical Significiancy Of Multimarker Index For Early Diagnosis Among The Patients Who Admitted To Emergency Department With Stroke Suspicion

Korkmaz¹,

Eren²,

Güven³

et al. 2009

TUTFD

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ÖZETAmaç: Serebrovasküler hastalıklar acil servislerde en sık karşılaşılan hastalıklar grubunu oluşturmaktadır. Bu çalışmada acil servise serebrovasküler hastalık şüphesi ile başvuran hastalarda erken tanı için plazmadaki MMX'in etkinliği ve ayrıca acil hekimi ile triyaj hekiminin tanılarının nöroloji hekiminin kesin tanısıyla korelasyonu incelendi.Gereç ve Yöntemler: Çalışma prospektif olup acil servise başvuran 83 hasta ile yapıldı. Önceden hazırlanmış formlara hasta bilgileri dolduruldu, hastalardan alınan 1cc venöz kan triyaj inme panel kiti cihazı ile değerlen-dirilerek sonuçlar patolojik veya normal olarak sınıflandırılıp hekim tanıları ile korelasyonuna bakıldı.Bulgular: Çalışmaya alınan 83 hastanın 44'ü (%53) erkek, 39'u (%47) kadındı. Yaş ortalaması 69.1 (37-90) olarak hesaplandı. Nöroloji hekiminin tanısı altın standart olarak alınıp triyaj, acil hekimi tanıları ve MMX inme değerleri ROC eğrisi analizi ile karşılaştırması yapıldığında aralarında anlamlı bir fark bulunmadı (p>0.05). Acil hekimi ile triyaj hekimi tanı oranları incelemesinde; acil hekiminin kesin ve muhtemel inme ön değerlendirme-si ile MMX sonuçları sırasıyla %100 ve %92.1, triyaj hekiminde ise sırasıyla %100 ve %96.4 uyumluluk saptandı.Sonuç: Bu çalışma sonucunda serebrovasküler hastalık şüphesi olan hastalarda triyaj panel kiti ile yapılan değerlendirme sonrasında MMX değerle-rinin yüksek bulunması durumunda hastanın inme olasılığının yüksek olduğu gösterilmekle beraber spesifite değerlendirmesi için daha fazla vakayla yapılacak çalışmalara ihtiyaç duyulduğu sonucuna varıldı. ABSTRACT Objective: Cerebrovascular diseases have a high rate in emergency services. We investigated the value of MMX in plasma for early diagnosis among the patients with suspected cerebrovascular disease and the correlation between the emergency, triage and neurology physician diagnoses. Material and Methods:It is a prospective study carried out with 83 patients. Pre-prepared forms were filled with the data about the patients. Samples of 1cc venous blood were measured for MMX and the results classified as normal or pathologic. The correlation between the results and physician diagnosis was investigated.Results: 44 (53%) of 83 patients were male, 39 (47%) were female. The average age was 69.1 (37-90) years. Neurology physician diagnosis, accepted as the gold standard, was compared with the triage, emergency physician diagnosis and MMX results by ROC curve analysis, and the difference was not significiant (p>0.05). When the diagnoses of the emergency physician were compared with the MMX results, the compatiblity for definite and probable strokes were 100% and 92.1%. The rates for triage physician were 100% and 96.4%. Conclusion:As a result of this study we can say that the stroke probablity is high if MMX is high in patients with suspected cerebrovascular disease, but more studies with large population groups are needed for specifity assessment.

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Serum neurone‐specific enolase as an indicator of stroke volume

Cited by 70 publications

References 19 publications

Correlation of Brain Biomarker Neuron Specific Enolase (NSE) with Degree of Disability and Neurological Worsening in Cerebrovascular Stroke

Correlation of Brain Biomarker Neuron Specific Enolase (NSE) with Degree of Disability and Neurological Worsening in Cerebrovascular Stroke

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

The Clinical Significiancy Of Multimarker Index For Early Diagnosis Among The Patients Who Admitted To Emergency Department With Stroke Suspicion

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