Is the Neuron-Specific Enolase (NSE) tumor marker used?

From the Guidelines

Yes, the NSE tumor marker is used clinically as a blood test to help diagnose, monitor, and manage certain types of cancers, primarily small cell lung cancer (SCLC), neuroblastoma, and neuroendocrine tumors. According to the European Respiratory Journal study 1, NSE is suggested as a potential intermediate criterion for survival in lung cancer patients. The study states that some circulating markers, including NSE, could be adequate intermediate criteria for survival in lung cancer patients.

Key Points:

• NSE is primarily used for SCLC, neuroblastoma, and neuroendocrine tumors.
• Normal NSE levels are typically below 16.3 ng/mL, with elevated levels potentially indicating the presence of these cancers.
• NSE is particularly valuable because it's produced by cells of neuronal origin and released into the bloodstream when these cells are damaged or rapidly dividing.
• However, NSE is not specific enough to be used alone for diagnosis, as levels can also rise in non-cancerous conditions like brain injury, sepsis, or hemolysis.
• Therefore, it's typically used alongside other diagnostic tools such as imaging studies, biopsies, and additional tumor markers to improve diagnostic accuracy and guide treatment decisions.

Additional Information:

• The Annals of Oncology study 1 mentions that determination of non-specific markers such as chromogranin A, NSE, urinary 5-HIAA, and serotonin are of clinical value in many NE-GEP tumors, including apparently non-functioning tumors.
• The Journal of the National Comprehensive Cancer Network study 1 states that nearly all SCLCs are immunoreactive for keratin, epithelial membrane antigen, and thyroid transcription factor-1, and most SCLCs also stain positively for markers of neuroendocrine differentiation, including chromogranin A, neuron-specific enolase, neural cell adhesion molecule (NCAM; CD56), and synaptophysin.

Overall, NSE is a valuable tool in the diagnosis and management of certain types of cancers, particularly SCLC, neuroblastoma, and neuroendocrine tumors.

From the Research

NSE Tumor Marker Usage

• The NSE tumor marker is used in the diagnosis, staging, and treatment of various neuroendocrine tumors (NETs) and other cancers, including small cell lung cancer (SCLC) 2, 3, 4.
• NSE is a highly specific marker for neurons and peripheral neuroendocrine cells, making it a useful index of neural maturation and a potential marker for neuroendocrine tumors 2, 5.
• Elevated serum levels of NSE have been found in various types of cancer, including SCLC, neuroblastoma, melanoma, seminoma, renal cell carcinoma, and others 2, 3, 4, 6.

Specific Cancers and NSE

• In small cell lung cancer (SCLC), NSE is currently the most reliable tumor marker for diagnosis, prognosis, and follow-up 2, 3, 4.
• In neuroblastoma, raised serum levels of NSE have been found in all stages of the disease, with higher incidence in widespread and metastatic disease 2.
• In lung adenocarcinoma, serum NSE may be a useful marker to predict neuroendocrine tumor transformation after EGFR-TKI therapy 6.

Comparison with Other Markers

• NSE has been compared with other tumor markers, such as carcinoembryonic antigen (CEA), and has been found to be a useful additional marker in monitoring SCLC and other cancers 4.
• Immunohistochemistry with NSE and other markers, such as chromogranin A and synaptophysin, has been used to identify neuroendocrine tumors and differentiate them from other types of cancer 5.