Neuron-specific Enolase (NSE)

CPT: 86316
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Test Details

Use

NSE is a useful adjunct in the monitoring of patients with small cell lung cancer (SCLC).

Limitations

NSE is not a screening test. Results for this test are for research purposes only by the assay's manufacturer. The performance characteristics of this product have not been established. Results should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.

Methodology

Enzyme immunoassay (EIA)

Reference Interval

0−12.5 ng/mL

Additional Information

Neuron specific enolase is one of the five isozymes of the glycolytic enzyme, enolase. This enzyme is released into the CSF when neural tissue is injured. Neoplasms derived from neural or neuroendocrine tissue may release NSE into the blood. The test may have value in predicting response to therapy. In a group of 13 patients with small cell carcinoma of lung, very high levels of NSE (≥100 ng/mL, mean of 490 ng/mL) were found in seven of eight responders. Levels <100 ng/mL (mean 28 ng/mL) were found in the remaining six patients, only two of whom were responders. These values are from samples obtained during the first three-day course of chemotherapy. There is evidence that the level of serum neuron-specific enolase correlates with tumor burden.1-3 Increase occurs more commonly and is at higher levels in advanced stage than in limited stage disease.3 The enzyme has been elevated in sera of all patients with three or more sites of metastases.1

Serum NSE levels are increased in cases of neuroblastoma,4 but also in other childhood tumors.5 Levels >100 ng/mL in children are, however, highly suggestive of advanced neuroblastoma. Use of NSE to monitor treated neuroblastoma patients has not been found to be a sensitive index of residual tumor.5 NSE levels may also be increased in some patients with seminoma6 and some patients with uremia who have been on dialysis.7

Specimen Requirements

Specimen

Serum

Volume

1 mL

Minimum Volume

0.3 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube or gel-barrier tube

Collection

Transfer separated serum to a plastic transport tube as quickly as possible after the clot has formed (within 30 minutes of collection).

Storage Instructions

Refrigerate.

Causes for Rejection

Hemolysis; plasma specimen; recently administered isotopes

Clinical Information

Special Instructions

Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This procedure does not provide serial monitoring; it is intended for one-time use only. If serial monitoring is required, please use the serial monitoring number 480137 to order.

Footnotes

1. Johnson DH, Marangos PJ, Forbes JT, et al. Potential utility of serum neuron-specific enolase levels in small cell carcinoma of the lung. Cancer Res. 1984 Nov; 44(11):5409-5414. 6091878
2. Anastasiades KD, Mullins RE, Conn RB. Neuron-specific enolase: Assessment by ELISA in patients with small cell carcinoma of the lung. Am J Clin Pathol. 1987 Feb; 87(2):245-249. 3028123
3. Akoun GM, Scarna HM, Milleron BJ, Benichou MP, Herman DP. Serum neuron-specific enolase. A marker for disease extent and response to therapy for small cell lung cancer. Chest. 1985 Jan; 87(1):39-43. 2981171
4. Ishiguro Y, Kato K, Ito T, Nagaya M, Yamada N, Sugito T. Nervous system-specific enolase in serum as a marker for neuroblastoma. Pediatrics. 1983 Nov; 72(5):696-700. 6356007
5. Cooper EH, Pritchard J, Bailey CC, Ninane J. Serum neuron-specific enolase in children's cancer. Br J Cancer. 1987Jul; 56(1):65-67. 3476145
6. Kuzmits R, Schernthaner G, Krisch K. Serum neuron-specific enolase: A marker for response to therapy in seminoma. Cancer. 1987 Sep 1; 60(5):1017-1021. 2440552
7. DeSanto NG, Veneroso S, Capodicasa G, Crisci A, Giordano C. Tumor markers in uremia: Carcinoembryonic antigen, neuron-specific enolase, carbohydrate antigen CA-50, and alpha-fetoprotein. Am J Nephrol., 1986; 6(6):458-463. 2436478

References

Kaiser E, Kuzmits R, Pregant P, Burghuber O, Worofka W. Clinical biochemistry of neuron specific enolase. Clin Chim Acta. 1989 Jul 31; 183(1):13-31 (review). 2548772
Virji MA, Mercer DW, Herberman RB. Tumor markers in cancer diagnosis and prognosis. Cancer J Clin. 1988 Mar-Apr; 38(2):104-126 (review). 3127000

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
140624 Neuron-specific Enolase, Serum 57371-7 140606 Neuron-specific Enolase, Serum ng/mL 57371-7

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