title: Serum neuron-specific enolase (S-NSE) in progressive small-cell lung cancer (SCLC).
abstract: Clinical decision making is based on results from qualitative and quantitative information. To provide quantitative data, various laboratory variables are widely used in the clinical evaluation of patients with small-cell lung cancer (SCLC). The tumour marker serum neuron-specific enolase (S-NSE) and the routine laboratory parameter serum lactate dehydrogenase (S-LDH) have been investigated, mostly separately. Few studies have compared their importance in SCLC, especially in progressive disease (PD). The present investigation was undertaken to evaluate S-NSE for diagnostic efficacy in PD and compare it with S-LDH. In 27 patients in a treatment trial of SCLC, regular follow-up laboratory values were prospectively obtained. Chemotherapy was given according to trial protocols, and all clinical evaluation followed the WHO recommendations. At re-evaluation all but three values had normalised (two S-NSE, one S-LDH). S-NSE at progression was increased in 93% of the patients and S-LDH in 59%. The efficacy of S-NSE to discriminate between response and PD was superior to S-LDH (0.92 vs 0.70). There was no additive effect of the two parameters in prediction of PD, and the discriminating power was higher for S-NSE than for S-LDH (P < 0.0008). The disease status-related marker increments in relation to upper reference limits, i.e. the signal-noise relation, were higher for S-NSE than for S-LD. Both of the markers carry information on PD. S-NSE is, however, clearly superior to S-LDH in reflecting disease status during therapy. This prompts us to conclude that S-NSE should replace S-LDH as prognostic factor and disease activity monitor in SCLC.
authors.affiliation: Department of Oncology ONK 5074, Rigshospitalet, Copenhagen, Denmark.
authors.forename: L G
authors.initials: LG
authors.lastname: Jørgensen
authors.forename: K
authors.initials: K
authors.lastname: Osterlind
authors.forename: H H
authors.initials: HH
authors.lastname: Hansen
authors.forename: E H
authors.initials: EH
authors.lastname: Cooper
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000201:enzymology*; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve
chemical_list: D014408:Biomarkers, Tumor; D007770:L-Lactate Dehydrogenase; D010751:Phosphopyruvate Hydratase