Reevaluaton of the usefulness of systematic bone scanning in initial staging and follow-up of small cell lung carcinoma, taking into account the serum levels of neuron-specific enolase.
The prescription of bone scans (BS) in the initial staging and follow-up of small cell lung carcinoma (SCLC) is a traditional attitude. The availability of the serum neuron-specific enolase (NSE) assay and budget limitations led us to evaluate retrospectively, in 57 patients, the consequences of a more selective attitude, namely to perform BS only in those patients with abnormal serum NSE levels. Both BS and NSE assays were performed in 47 patients referred for initial staging of SCLC; NSE levels were normal in 8 but in 2 of these cases (25%) secondary bone localizations with great clinical significance were discovered at BS. During follow-up, 59 BS were performed in conjunction with NSE assays; 45 NSE levels were in the normal range whereas 17 (38%) corresponding BS were suggestive of bone metastases. In conclusion, due to the frequent occurrence of false-negative results in patients with bone metastases, serum NSE levels proved to be useless in the selection for BS of patients suffering from SCLC.
Gendreau
V
V
Services de Médecine Nucléaire, Hôpital Tenon, Paris, France.
Montravers
F
F
Philippe
C
C
Talbot
J N
JN
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D018288:Carcinoma, Small Cell / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D003955:Diagnostic Tests, Routine; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D010751:Phosphopyruvate Hydratase