Profile of Neuron-Specific Enolase, Lactate Dehydrogenase, Fine Needle Aspiration Biopsy, and Bone Marrow Aspiration Examination to Diagnose Neuroblastoma Patients in Hematology Oncology Division of Pediatric Department at Dr. Soetomo General Hospital

Background: Neuroblastoma is a Malignant solid tumour in children which attacks sympathetic nervous system. Despite of increment in its number of incidence, it is still rarely investigated. This research aims to improve the understanding of neuroblastoma based on the profile of patients, and further, to improve services for patients.Methods: This was a retrospective study conducted by assessing and descriptively analyzed patients medical record.Results: From 52 patients, 56% were male and 71% were between age of 1-5 years. Neuron Specific Enolase (NSE) examination showed that most patients had high levels in 29 patients (56%) while Lactate Dehydrogenase (LDH) examination showed that 23 patients (44%) had low levels. Based on Fine Needle Aspiration Biopsy (FNAB) examination, 22 patients (42%) showed formation of Malignant round cell tumor. Meanwhile, through Bone Marrow Aspiration (BMA) examination, it was found that the tumors had already spread to bone marrow in 17 patients (33%).Conclusions: Based on tumor markers and pathological finding, this study revealed that the majority of neuroblastoma patients had poor prognosis

Serum neuron-specific enolase in children's cancer.

To test its diagnostic potential and sensitivity in paediatric malignancy, serum NSE was measured at diagnosis in 191 children with solid tumours and 25 with acute leukaemia. In stages I + II, III + IV and IVs neuroblastoma median levels were 18.0, 91.0 and 24.0 ng ml-1 respectively. For Wilms' patients, median values for stages I, II, III and IV disease were 16.6, 18.0, 29.0 and 47.0 ng ml-1 respectively. High levels of NSE were also found in patients with other types of tumour. Children in clinical remission after treatment for neuroblastoma invariably had normal NSE levels (mean +/- s.d. = 9.2 +/- 3.0 ng ml-1) even though the majority had radiologically identifiable residual disease. The values rose when relapse was radiologically or clinically obvious. We conclude (a) that, though levels of greater than 100 ng ml-1 are highly suggestive of advanced neuroblastoma, caution should be exercised in using serum NSE as a diagnostic test in children with cancer and (b) that serum NSE levels are not a sensitive index of residual neuroblastoma in patients, with initially elevated levels, that are receiving treatment

New and old biomarkers in the differential diagnosis of lung cancer: Pro-gastrin-releasing peptide in comparison with neuron-specific enolase, carcinoembryonic antigen, and CYFRA 21-1.

Background: Testing for circulating biomarkers in lung cancer is hampered by the insufficient specificity. We aimed to assess the relative diagnostic accuracy of pro-gastrin-releasing peptide (ProGRP) for the differential diagnosis of small cell lung cancer and compare it with more conventional biomarkers. Methods: We enrolled a cohort of 390 patients with a clinical suspicion of lung cancer and for whom a histologic assessment was available. Serum or plasma samples were assessed for ProGRP, carcinoembryonic antigen, CYFRA 21-2, and neuron-specific enolase. The performance of each biomarker in discriminating the small cell lung cancer and squamous cell carcinoma/adenocarcinoma from non-malignant lung disease, and small cell lung cancer from squamous cell carcinoma/adenocarcinoma, was assayed by receiver operating characteristic curve analysis. Results: At the cut-off levels suggested by the manufacturers, ProGRP and neuron-specific enolase showed an almost identical sensitivity of 55.2% and 55.6%, respectively, in discriminating small cell lung cancer with respect to non-malignant lung disease. In order to quantify the added value of ProGRP to other conventional markers, we ran a multivariable logistic regression analysis, but the results showed that no markers improve the performance of ProGRP. Conclusions: ProGRP and neuron-specific enolase individually appear more accurate than other conventional biomarkers for small cell lung cancer, but the union of two markers does not increase the accuracy. The very small target group of patients with small cell lung cancer is a limitation of this study, which can explain why ProGRP alone does not show a sensitivity higher than neuron-specific enolase, as reported by other authors

Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease

Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. Toluidine blue stain can act as a double check along with conventional H&E stain for ganglion cell detection. Neuron-specific enolase is an immune-histochemical marker that can also aid in better identifying ganglion cells, especially for small and immature ones. This study aimed to evaluate Toluidine blue stain and Neuron specific enolase immunostain along with conventional H&E stain as a panel for the diagnosis of Hirschsprung disease. This cross-sectional study was conducted from September 2019 to August 2021, involving 55 clinically suspected Hirschsprung disease cases. Paraffin blocks of colorectal biopsy samples were collected from the Department of Pathology, BSMMU. Hematoxylin & Eosin, Toluidine blue stain, and Neuron specific enolase immunohistochemical stain for Hirschsprung disease detection were performed on the sections from the paraffin blocks. Then the sections were examined and an evaluation of the stains was done. Statistical analysis was performed on the tabulated data by chi-square test. Among 55 cases, conventional H&E stain detected ganglion cells in 31 cases, that is 56.4%. Later, Toluidine blue stain and Neuron specific enolase immu- nohistochemical stain detected ganglion cells in 35 cases, that is 63.6%. So, these two addition- al stains were able to detect ganglion cells in four more cases compared to conventional H&E stain. In conclusion, conventional H&E stain, Toluidine blue stain, and NSE immunohisto- chemical stain can improve the diagnostic accuracy of Hirschsprung disease. BSMMU J 2022; 15(2): 102-10

Technical performance and diagnostic utility of the new Elecsys (R) neuron-specific enolase enzyme immunoassay

This international multicenter study was designed to evaluate the technical performance of the new double-monoclonal, single-step Elecsys neuron-specific enolase (NSE) enzyme immunoassay (EIA) and to assess its utility as a sensitive and specific test for the diagnosis of small-cell lung cancer (SCLC). Intra and interassay coefficients of variation, determined in five control or serum specimens in six laboratories, ranged from 0.7 to 5.3 (interlaboratory median: 1.3%) and from 1.3 to 8.5 (interlaboratory median: 3.4%), respectively. Laboratory-to-laboratory comparability was excellent with respect to recovery and interassay coefficients of variation. The test was linear between 0.0 and 320 ng/ml (highest measured concentration). There was a significant correlation between NSE concentrations measured using the Elecsys NSE and the established Cobas Core NSE EIA II in all subjects (n=723) and in patients with lung cancer (n=333). However, NSE concentrations were systematically lower (approximately 9%) with the Elecsys NSE than with the comparison test. Based on a specificity of 95% in comparison with the group suffering from benign lung diseases (n=183), the cutoff value for the discrimination between malignant and benign conditions was set at 21.6 ng/ml. NSE was raised in 73.4% of SCLC patients (n=188) and was significantly higher (p<0.01) in extensive (87.8%) as opposed to limited disease (56.7%). NSE was also elevated in 16.0% of the cases with non-small cell lung cancer (NSCLC, n=374). It is concluded that the Elecsys NSE EIA is a reliable and accurate diagnostic procedure for the measurement of NSE in serum samples. The special merits of this new assay are the wide measuring range (according to manufacturers declaration up to 370 ng/ml) and a short incubation time of 18 min

저산소뇌증 환자에서 혈청 Neuron-Specific Enolase 수치와 예후

Background: Hypoxic brain damage is a critical situation and needs emergent treatment. Even with a successful treatment of the underlying causative disease, the extent of injury to brain parenchyma is often severe and irreversible. Clinical outcome of hypoxic brain damage is determined by the degree of diffuse brain damage. Although neuroimaing and electrophysiological study help to predict the clinical outcome, it is often difficult to perform these test because of unstable vital sign and technical problem. Therefore, reliable and feasible methods for early prediction of prognosis need to be established. Methods: This study included 22 patients with hypoxic brain damage after resuscitation. Serum Neuron-Specific Enolase (NSE) level within 24 hours after resuscitation was measured by enzyme immunoassay. Clinical outcome was assessed by the use of Glasgow Outcome Scale (GOS) at 6 months after onset. Results: In 22 patients, 18 (81.8%) patients had poor outcome, and 4 (19.2%) patients showed favorable recovery. A serum NSE concentration above 20 ng/mL was found to be a predictor of poor outcome with a high positive predictive value (93.8%). Concentrations more than 22 ng/mL predicted poor outcome with a high specificity (100%) and a positive predictive value of 100%. Conclusion: In patients with hypoxic brain damage, serum NSE concentrations of >22 ng/mL was predictive of poor clinical outcome with a high specificity. We suggest that serum NSE may be a feasible and valuable biochemical marker for prediction of clinical outcome in hypoxic brain damageope

Plasma neuronal specific enolase : a potential stage diagnostic marker in human African trypanosomiasis

© The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: [email protected]. Funding: This work was supported through grants from the Wellcome Trust [082786] and Foundation for Innovative New Diagnostics.Peer reviewedPublisher PD

CEA, CYFRA 21-1, NSE, and ProGRP in the diagnosis of lung cancer: a multivariate approach

We retrospectively studied the single and combined diagnostic value of carcinoembryonic antigen (CEA), cytokeratin fragment 19 (CYFRA 21-1), neuron specific enolase (NSE) and pro-gastrin-releasing peptide (ProGRP), which were routinely analysed in patients with lung tumours of unknown origin at the time of admission to hospital. Inclusion criteria were the determination of CEA (AxSYM/Abbott), CYFRA 21-1 (ElecSys/Roche) and NSE (Kryptor/Brahms). We examined 1747 patients, where 1325 suffered from lung cancer (LC; small cell lung cancer, SCLC: n=194; non-small cell lung cancer, NSCLC: n = 1015; others: n = 116), 318 from benign lung diseases and 104 from lung metastases due to another primary malignancy. As ProGRP (ELISA ALSI/IBL) became available only recently, there are less data points of this marker. In total, 99.8% of LC patients released at least one of the four biomarkers (defined as values exceeding the median of healthy controls), and for the discrimination between benign disease (BID) and malignant lung disease each marker reached 100% tumour specificity at high levels (CEA: 20 ng/mL; CYFRA 21-1: 40 ng/mL; NSE: 45 ng/mL; ProGRP: 250 pg/mL). At a specificity of > 99%, ProGRP reached the highest diagnostic efficacy for SCLC with 57% true positive results, CEA had the highest capacity (17%) to detect malignant lung tumours in general and adenocarcinomas of the lung with 29%. CYFRA 21-1 was dominant for squamous cell carcinomas (12%). Combining the four markers leads with the prerequisite of high specificity (> 99%) to 50% true positives for malignant lung tumours, 44% for NSCLC, 36% for squamous cell carcinomas, 53% for adenocarcinomas, and 78% for SCLC, respectively. In cases of lung tumours of unknown origin, the combined use of CEA, CYFRA 21-1, NSE and ProGRP is useful for the differentiation between benign and primary or secondary malignant disease and suggests the assignment to histological subtypes