open access

Vol 78, No 1 (2010)
ORIGINAL PAPERS
Published online: 2010-01-29
Submitted: 2013-02-22
Get Citation

Elevated serum NSE level in locally advanced and metastatic NSCLC predispose to better response to chemotherapy but worse survival

Monika Załęska, Monika Szturmowicz, Jacek Zych, Barbara Roszkowska-Śliż, Urszula Demkow, Renata Langfort, Kazimierz Roszkowski-Śliż
Pneumonol Alergol Pol 2010;78(1):14-20.

open access

Vol 78, No 1 (2010)
ORIGINAL PAPERS
Published online: 2010-01-29
Submitted: 2013-02-22

Abstract

The aim of the study was to evaluate the predictive and prognostic values of elevated serum levels of selected cancer markers (NSE, Cyfra 21-1, CEA, ferritin, free beta-hCG, LDH) in patients with inoperable non-small-cell lung cancer (NSCLC). We investigated a group of 79 patients (49 men and 30 women) with NSCLC. Multivariate regression analysis showed response in patients with NSE > 12.5 ng/ml (p = 0.002), good performance status (p = 0.007) and elderly patients (p = 0.005). However, elevated NSE adversely affected the prognosis. Median survival in patients with NSE < 12.5 ng/ml, 12.5-20.0 ng/ml and > 20.0 ng/ml was 13.3, 11.3 and 6.7 months, respectively (p = 0.004). The negative effect of elevated NSE was independent of the response category. Univariate regression analysis showed that the following factors had a significantly negative effect on the prognosis: performance status, stage IIIB or IV, weight loss of > 10%, NSE > 20 ng/ml, Cyfra 21-1 > 10 ng/ml, CEA > 3 ng/ml, ferritin ratio > 1 and LDH > 480 IU/l. Multivariate analysis showed an independent adverse prognostic effect of stage IIIB or IV and elevated ferritin.

Abstract

The aim of the study was to evaluate the predictive and prognostic values of elevated serum levels of selected cancer markers (NSE, Cyfra 21-1, CEA, ferritin, free beta-hCG, LDH) in patients with inoperable non-small-cell lung cancer (NSCLC). We investigated a group of 79 patients (49 men and 30 women) with NSCLC. Multivariate regression analysis showed response in patients with NSE > 12.5 ng/ml (p = 0.002), good performance status (p = 0.007) and elderly patients (p = 0.005). However, elevated NSE adversely affected the prognosis. Median survival in patients with NSE < 12.5 ng/ml, 12.5-20.0 ng/ml and > 20.0 ng/ml was 13.3, 11.3 and 6.7 months, respectively (p = 0.004). The negative effect of elevated NSE was independent of the response category. Univariate regression analysis showed that the following factors had a significantly negative effect on the prognosis: performance status, stage IIIB or IV, weight loss of > 10%, NSE > 20 ng/ml, Cyfra 21-1 > 10 ng/ml, CEA > 3 ng/ml, ferritin ratio > 1 and LDH > 480 IU/l. Multivariate analysis showed an independent adverse prognostic effect of stage IIIB or IV and elevated ferritin.
Get Citation

Keywords

neuron specific enolase; non-small-cell lung cancer; prognosis; response to treatment

About this article
Title

Elevated serum NSE level in locally advanced and metastatic NSCLC predispose to better response to chemotherapy but worse survival

Journal

Advances in Respiratory Medicine

Issue

Vol 78, No 1 (2010)

Pages

14-20

Published online

2010-01-29

Bibliographic record

Pneumonol Alergol Pol 2010;78(1):14-20.

Keywords

neuron specific enolase
non-small-cell lung cancer
prognosis
response to treatment

Authors

Monika Załęska
Monika Szturmowicz
Jacek Zych
Barbara Roszkowska-Śliż
Urszula Demkow
Renata Langfort
Kazimierz Roszkowski-Śliż

References (28)
  1. Barlési F, Gimenez C, Torre JP, et al. Prognostic value of combination of Cyfra 21-1, CEA and NSE in patients with advanced non-small cell lung cancer. Respir Med. 2004; 98(4): 357–362.
  2. Ebert W, Dienemann H, Fateh-Moghadam A, et al. Cytokeratin 19 fragment CYFRA 21-1 compared with carcinoembryonic antigen, squamous cell carcinoma antigen and neuron-specific enolase in lung cancer. Results of an international multicentre study. Eur J Clin Chem Clin Biochem. 1994; 32(3): 189–199.
  3. Ferrigno D, Buccheri G, Biggi A. Serum tumour markers in lung cancer: history, biology and clinical applications. Eur Respir J. 1994; 7(1): 186–197.
  4. Ferrigno D, Buccheri G, Giordano C. Neuron-specific enolase is an effective tumour marker in non-small cell lung cancer (NSCLC). Lung Cancer. 2003; 41(3): 311–320.
  5. van Zandwijk N, Jassem E, Bonfrer JM, et al. Serum neuron-specific enolase and lactate dehydrogenase as predictors of response to chemotherapy and survival in non-small cell lung cancer. Semin Oncol. 1992; 19(1 Suppl 2): 37–43.
  6. Zych J, Szturmowicz M, Sakowicz A, et al. [Neuron-specific enolase (NSE) serum level as a prognostic factor in non-small cell lung cancer]. Pneumonol Alergol Pol. 2002; 70(5-6): 278–283.
  7. World Health Organization.. Histological typing of lung cancer tumors. In: International classification of tumors. 2 nd ed. WHO, Geneva 1981.
  8. Reif PT, Rivera MP. Evidence-base outcomes for patients with advanced non-small cell leng cancer. Semin. Respir. Crit. Care Med. 2000; 21: 1–16.
  9. Mountain CF. Revisions in the International System for Staging Lung Cancer. Chest. 1997; 111(6): 1710–1717.
  10. Moran CA, Suster S, Coppola D, et al. Neuroendocrine carcinomas of the lung: a critical analysis. Am J Clin Pathol. 2009; 131(2): 206–221.
  11. Carles J, Rosell R, Ariza A, et al. Neuroendocrine differentiation as a prognostic factor in non-small cell lung cancer. Lung Cancer. 1993; 10(3-4): 209–219.
  12. Sundaresan V, Reeve JG, Stenning S, et al. Neuroendocrine differentiation and clinical behaviour in non-small cell lung tumours. Br J Cancer. 1991; 64(2): 333–338.
  13. Linnoila RI, Piantadosi S, Ruckdeschel JC. Impact of neuroendocrine differentiation in non-small cell lung cancer. The LCSG experience. Chest. 1994; 106(6 Suppl): 367S–371S.
  14. Graziano SL, Tatum AH, Newman NB, et al. The prognostic significance of neuroendocrine markers and carcinoembryonic antigen in patients with resected stage I and II non-small cell lung cancer. Cancer Res. 1994; 54(11): 2908–2913.
  15. Slodkowska J, Zych J, Szturmowicz M, et al. Neuroendocrine phenotype of non-small cell lung carcinoma: immunohistological evaluation and biochemical study. Int J Biol Markers. 2005; 20(4): 217–226.
  16. Pelosi G, Pasini F, Sonzogni A, et al. Prognostic implications of neuroendocrine differentiation and hormone production in patients with Stage I nonsmall cell lung carcinoma. Cancer. 2003; 97(10): 2487–2497.
  17. Hiroshima K, Iyoda A, Shibuya K, et al. Prognostic significance of neuroendocrine differentiation in adenocarcinoma of the lung. Ann Thorac Surg. 2002; 73(6): 1732–1735.
  18. Ruibal A, Nuñez MI, Rodríguez J, et al. Cytosolic levels of neuron-specific enolase in squamous cell carcinomas of the lung. Int J Biol Markers. 2003; 18(3): 188–194.
  19. Nisman B, Heching N, Biran H, et al. The prognostic significance of circulating neuroendocrine markers chromogranin a, pro-gastrin-releasing peptide and neuron-specific enolase in patients with advanced non-small-cell lung cancer. Tumour Biol. 2006; 27(1): 8–16.
  20. Pujol JL, Boher JM, Grenier J, et al. Cyfra 21-1, neuron specific enolase and prognosis of non-small cell lung cancer: prospective study in 621 patients. Lung Cancer. 2001; 31(2-3): 221–231.
  21. Maeda T, Ueoka H, Tabata M, et al. Prognostic factors in advanced non-small cell lung cancer: elevated serum levels of neuron specific enolase indicate poor prognosis. Jpn J Clin Oncol. 2000; 30(12): 534–541.
  22. Akerley W, Crowley J, Giroux D, et al. Response to chemotherapy as a predictor of survival in advanced non-small cell lung cancer (NSCLC): Review of the Southwest Oncology Group (SWOG) database. Lung Cancer. 2000; 29(1): 33.
  23. Betticher DC, Hsu Schmitz SF, Tötsch M, et al. Swiss Group for Clinical Cancer Research (SAKK). Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study. Br J Cancer. 2006; 94(8): 1099–1106.
  24. Johnson K, Ringland C, Stokes B, et al. Response rate or time to progression as predictors of survival in trials of metastatic colorectal cancer or non-small-cell lung cancer: a meta-analysis. The Lancet Oncology. 2006; 7(9): 741–746.
  25. Diez M, Torres A, Ortega L, et al. Value of serum neuron-specific enolase in nonsmall cell lung cancer. Oncology. 1993; 50(2): 127–131.
  26. Hatzakis KD, Froudarakis ME, Bouros D, et al. Prognostic value of serum tumor markers in patients with lung cancer. Respiration. 2002; 69(1): 25–29.
  27. Foa P, Fornier M, Miceli R, et al. Preoperative CEA, NSE, SCC, TPA and CYFRA 21.1 serum levels as prognostic indicators in resected non-small cell lung cancer. Int J Biol Markers. 1999; 14(2): 92–98.
  28. Reinmuth N, Brandt B, Semik M, et al. Prognostic impact of Cyfra21-1 and other serum markers in completely resected non-small cell lung cancer. Lung Cancer. 2002; 36(3): 265–270.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl