肺非小細胞における血清 neuron-specific enolase (NSE) 測定の臨床的意義

In an attempt to elucidate the clinical sigificance of serum NSE leval in patients with advaced NSCLC, I determined the pretreatment serum NSE levels in 154 patients who received chemotherapy. Of them, 45(29%) showed an elevated leved of ≧ 10ng/ml. Patients with elevated NSE level were significantly more frequent in stage Ⅳ than in stage Ⅲ. The median duration of response to chemotherapy was significantly shorter in patient with an elevated level than in those with a non-elevated level (4.9 months vs 6.7 months ; p<0.05). Patients showing an elevated NSE level survived significantly shorter than those showing a non-elevated level (6.2 months vs 13.1 months ; p<0.001). A multivariate analysis revealed that the pretreatment NSE level, clinical stage, and pretreatment serum albumin level were independent prognostic factors in patients with advanced NSCLC receiving chemotherapy. Additionally, I stained 46 tumor specimens histochemically using the anti- NSE antibody. However, the stainability did not correlate with the serum NSE level. These findings indicate that the elevated NSE in the sera did not originate in the expression of neuroendocrine nature of NSCLC tumors but in the bulk of tumors and cell kinetic characterisitics. e. g., rapid growth with large cell death.

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