Specific serum marker for the family of neuroendocrine tumors of amine precursor uptake and decarboxylation series, which includes neuroblastoma, retinoblastoma, medullary carcinoma of thyroid, carcinoid, pancreatic cell carcinoma, pheochromocytoma, and small cell carcinoma of the lung (SCLC)
Normal range: 3.7 " “8.9 Ž ¼g/L
Use
A follow-up marker in patients with NSE-secreting tumors of any type
An auxiliary test in the diagnosis of SCLC
An auxiliary test in the diagnosis of carcinoids, islet cell tumors, and neuroblastomas
An auxiliary tool in the assessment of comatose patients
Interpretation
NSE in both serum and CSF is a sensitive and specific marker of neuronal injury in various neurologic disorders.
NSE is increased in neuroblastoma and SCLC.
Useful in the differentiated diagnosis of Creutzfeldt-Jakob disease for other dementing disease.
Limitations
All NSE test results must be considered in the clinical context, and interferences or artifactual elevations should be suspected if the clinical NSE test results are at odds with the clinical picture or other tests. Not a screening test.
Hemolysis can lead to significant artifactual NSE elevations, because erythrocytes contain NSE.
Proton pump inhibitor treatment, hemolytic anemia, hepatic failure, and end-stage renal failure can also result in artifactual NSE elevations.
When performing NSE testing for tumor diagnosis or follow-up, epileptic seizure, brain injury, encephalitis, stroke, and rapidly progressive dementia might result in false-positive results. On the other hand, when NSE testing is performed to assist in neurologic diagnosis, NSE-secreting tumors can represent a source of false-positive results.
NSE values can vary significantly between methods/assays. Serial follow-up should be performed with the same assay. If assays are changed, patients should be rebaselined.