Determination of neuron specific enolase [NSE] in small cell lung carcinoma [SCLC] and non-small cell lung carcinoma [NSCLC] patients

ABSTRACT

Neuron specific enolase [NSE] is routinely used as tumor marker in Small cell lung carcinoma [SCLC], and to some extent in non-small cell lung carcinoma [NSCLC]. In Pakistan, tumor marker technology is not a new one. It is however mostly directed towards uses in hepatic, breast, ovarian, uterine and colorectal cancers, whereas availability and general practice of its use for diagnosis of respiratory metastasizing disease such as lung cancer is seldom and rare, especially the SCLC/NSCLC specific NSE. The aim of present study is to determine the potential usefulness of NSE in diagnosis and prognosis of SCLC and NSCLC patients in our setting. Fifty-eight patients of lung cancer were identified and selected, between January 2004 to December 2007, and divided into various groups depending upon their clinical stage of disease. NSE level was determined in all patients and clinical history data and related pathophysiological components of all selected patients were carefully assessed and compulsorily followed to avoid any bias. Cancer status of patients were evaluated by data available from multiple bronchoscopies, X rays, cytology and histopathology examinations and grouped as SCLC with all five stages [I, II, IIIA, IIIB and IV] and NSCLC with only stage IV. NSE level was also determined in Healthy subjects and patients with non-malignant lung diseases [NMLD] for comparison. We observed significant elevation in levels in NSE for different stages of SCLC and NSCLC in comparison with healthy and NMLD groups. Most significant increase was noted in SCLC stage IV not only in comparison with healthy [P <0.001] and NMLD groups [P < 0.001] but also with stage I [P <0.001] within the group. Elevated difference in NSE levels was also correlated with stage II, IIIA and IIIB of SCLC group. As regard NSCLC, where patients belonged only to stage IV of disease, significant difference was observed with healthy [P <0.01] when compared with NSCLC, whereas non-significant difference in NSE levels was noted in group-SCLC stage II, IIIA and IIIB. In comparison, all stage IV patients [n=7] of SCLC exhibited higher levels of NSE with a range of 136.19 ng/ml to 175.01 ng/ml, higher than detected in patents of stage IV in NSCLC. The result of our study suggests that NSE appears to be a useful tumor marker for SCLC and to some extent, NSCLC. Moreover, NSE exhibits higher levels in some stages of SCLC suggesting, its specificity, not only for advanced stage of SCLC but also for SCLC in general as compared to NSCLC. Its determination, therefore, is beneficial in the diagnosis, treatment and a possible follow-up for patients survival