Test Background NSE is a glycolytic enzyme enolase (2-phospho-D-glyceratehydrolase) normally present in neurones, peripheral nerve tissues and neuroendocrine tissues, especially in the cells of the Amine Precursor Uptake Decarboxylation (APUD) system. It is in the form of dimers αγ and γγ with a molecular weight of approximately 95 kDa. Elevated levels occur in tumours of neuroectodermic or neuroendocrine origin, namely small-cell carcinoma of the lungs (SCLC), neuroblastoma, medullary thyroid carcinoma, carcinoid tumours, pancreatic endocrine tumours, seminoma and melanoma. Moderate elevations are also seen in some colorectal and breast cancers, and in patients with benign lung diseases.
Clinical IndicationsLung cancer
Diagnosis: although NSE does not have sufficient sensitivity or specificity for use in screening, several studies support its use as an aid in the diagnosis of SCLC. High serum levels of NSE (>100 μg/L) in patients with suspicion of malignancy suggest the presence of SCLC with high probability, with differential diagnoses including neuroendocrine tumours of other organs.
Prognosis and monitoring: the prognostic value of NSE has been demonstrated in both SCLC and non-small cell lung cancer (NSCLC). NSE has shown considerable potential for the monitoring of post-treatment SCLC as well as for the detection of recurrent disease after primary therapy.
Treatment and follow-up monitoring of neuroblastoma.
Differential diagnosis between Wilm’s tumour and neuroblastoma in children.
Roche Cobas E411 method. As NSE is present in erythrocytes, plasma cells and platelets, serum or plasma must be separated from red cells within 60 minutes of venepuncture to avoid spuriously high results.