Splinter T A, Cooper E H, Kho G S, Oosterom R, Peake M D
Department of Oncology, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Eur J Cancer Clin Oncol. 1987 Feb;23(2):171-6. doi: 10.1016/0277-5379(87)90011-3.
A retrospective evaluation of serial measurements of neuron-specific enolase (NSE) has been performed in 58 patients with small cell lung cancer (SCLC). All 58 patients received first-line chemotherapy and 11 patients received also second-line treatment after relapse. Samples were obtained every 3-4 weeks during treatment before each cycle of chemotherapy and every 6 or 12 weeks during follow-up. NSE values were depicted on semi-logarithmic paper. Fifty-one times a major response (complete or partial remission) was observed and 49 times the NSE level reached a plateau between 3.5-10 ng/ml. The NSE level did not discriminate between a complete or a partial remission. Seven times stable disease was obtained and the NSE level declined but remained above the normal plateau of 3.5-10 ng/ml. On 50 occasions progressive disease was found. In 3 cases progressive disease was due to a histologically-proven non-small cell lung cancer and NSE levels did not change. In only 5 out of the remaining 47 occasions NSE levels were normal at the time of relapse but rose later in 4. On 42 occasions of progressive SCLC an exponential rise of NSE was found, often within the range of 3.5-20 ng/ml. None of 6 patients, who are still incomplete remission for 1-5 years, showed a consistent rise of NSE. Serial measurements of serum NSE, can predict the occurrence of a major response, stable disease and progressive disease outside the brain with a very high accuracy and seem to be at least a useful addition to standard investigational methods to guide the treatment of SCLC.
对58例小细胞肺癌（SCLC）患者进行了神经元特异性烯醇化酶（NSE）系列测量的回顾性评估。所有58例患者均接受一线化疗，11例患者复发后还接受了二线治疗。在治疗期间，每3 - 4周在每个化疗周期前采集样本，随访期间每6或12周采集样本。NSE值绘制在半对数纸上。观察到51次主要缓解（完全或部分缓解），49次NSE水平在3.5 - 10 ng/ml之间达到平台期。NSE水平无法区分完全缓解或部分缓解。获得7次疾病稳定，NSE水平下降但仍高于3.5 - 10 ng/ml的正常平台期。发现50次疾病进展。在3例中，疾病进展是由于组织学证实的非小细胞肺癌，NSE水平未改变。在其余47次中，只有5次复发时NSE水平正常，但4次后来升高。在42次SCLC进展的情况下，发现NSE呈指数上升，通常在3.5 - 20 ng/ml范围内。6例仍处于不完全缓解1 - 5年的患者中，没有一例显示NSE持续升高。血清NSE的系列测量能够以非常高的准确性预测脑外主要缓解、疾病稳定和疾病进展的发生，似乎至少是标准研究方法的有用补充，以指导SCLC的治疗。
