Do neuron-specific enolase levels discriminate between small-cell lung cancer and mediastinal tumors?
The capacity of pretherapeutically assessed neuron-specific enolase (NSE) to differentiate between small cell lung cancer (SCLC) and mediastinal tumors was investigated retrospectively in a series of 320 patients. NSE was found to be increased in 95/130 (73.1%) patients with SCLC, in 4/62 (6.5%) patients with Hodgkin's disease, in 10/58 (17.2%) patients with non-Hodgkin's lymphoma, in 5/16 (31.3%) patients with teratoma, and in 6/54 (11.1%) patients with thymoma. The cut-off value, defined as the 95% percentile of a reference population suffering from benign pulmonary disorders (n = 192), was set at 13.8 ng/ml. When this discrimination level was increased to 26.4 ng/ml, which corresponds to a 95% specificity versus the total group with mediastinal tumors, SCLC was recognized with a detection rate of only 49.2%. In conclusion, increased NSE concentrations in a patient with a hilar mass and/or mediastinal widening on X-ray are not always diagnostic of SCLC due to the high rate of elevated NSE values associated with mediastinal tumors. However, in a patient who presents with a hilar mass and a high NSE level, bronchoscopy is always indicated to obtain adequate specimens for histology in order to plan an appropriate therapeutic regimen.
Ebert
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W
Thoraxklinik Heidelberg-Rohrbach, Heidelberg, Deutschland.
Ryll
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R
Muley
T
T
Hug
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G
Drings
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P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000201:enzymology*; D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000201:enzymology*; D008223:Lymphoma / Q000175:diagnosis / Q000201:enzymology*; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000201:enzymology*; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013724:Teratoma / Q000175:diagnosis / Q000201:enzymology; D013945:Thymoma / Q000175:diagnosis / Q000201:enzymology; D013953:Thymus Neoplasms / Q000175:diagnosis / Q000201:enzymology
D010751:Phosphopyruvate Hydratase