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Neurone Specific Enolase (NSE)

Category Biochemistry >> Oncology
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 Indications

Lung 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.

Other uses

- Treatment and follow-up monitoring of neuroblastoma.
- Differential diagnosis between Wilm’s tumour and neuroblastoma in children.

Reference range

≤16.3 µg/LSST (gold top) preferred, serum (red top) accepted

Sample & container required SST (gold top) preferred, serum (red top) accepted
Sample volume 0.5 mL
Transport storage Samples should be stored at -20ºC within 24 hours of separation. Send samples frozen.
Turnaround time 4 weeks

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.

Falsely low results may be obtained for this test due to biotin interference. Samples should not be taken from patients receiving therapy with high biotin doses (>5 mg/day) until at least 8 hours (ideally 2 days) following the last biotin administration.

Haemolysed samples are not suitable for analysis.