Neuron-Specific Enolase (NSE), Serum

Test ID:

703053

CPT code:

86316

Clinical Use:

NSE is a useful adjunct in the monitoring of patients with small cell lung cancer (SCLC).

Test Information:

Neuron specific enolase is one of the five isozymes of the glycolytic enzyme, enolase. This enzyme is released into the CSF when neural tissue is injured. Neoplasms derived from neural or neuroendocrine tissue may release NSE into the blood. The test may have value in predicting response to therapy. In a group of 13 patients with small cell carcinoma of lung, very high levels of NSE (≥100 ng/mL, mean of 490 ng/mL) were found in seven of eight responders. Levels <100 ng/mL (mean 28 ng/mL) were found in the remaining six patients, only two of whom were responders. These values are from samples obtained during the first three-day course of chemotherapy. There is evidence that the level of serum neuron-specific enolase correlates with tumor burden.1-3 Increase occurs more commonly and is at higher levels in advanced stage than in limited stage disease.3 The enzyme has been elevated in sera of all patients with three or more sites of metastases.1Serum NSE levels are increased in cases of neuroblastoma,4 but also in other childhood tumors.5 Levels >100 ng/mL in children are, however, highly suggestive of advanced neuroblastoma. Use of NSE to monitor treated neuroblastoma patients has not been found to be a sensitive index of residual tumor.5 NSE levels may also be increased in some patients with seminoma6 and some patients with uremia who have been on dialysis