Department of Thoracic Surgery, China-Japan Friendship Hospital, #2 Yinghua East Road, Chaoyang District, Beijing, 100029, China.
World J Surg Oncol. 2020 May 30;18(1):116. doi: 10.1186/s12957-020-01894-9.
Neuron-specific enolase (NSE) has become a widely used and easily attainable laboratory assay of small cell lung cancer (SCLC). However, the prognostic value of NSE for SCLC patients remains controversial. The aim of the study was to evaluate the correlation between elevated serum NSE before therapy and survival of SCLC patients.
We performed a systematic review and meta-analysis. A systematic literature search was conducted in PubMed, Embase, and the Cochrane Central Register from the inception dates to December 2019. Eligible articles were included according to inclusion and exclusion criteria; then, data extraction and quality assessment were performed. The primary outcome was overall survival (OS), and the secondary endpoint was progression-free survival (PFS).
We identified 18 studies comprising 2981 patients. Pooled results revealed that elevated NSE was associated with worse OS (HR = 1.78, 95% CI 1.55-2.06, p < 0.001) and PFS (HR = 1.50, 95% CI 1.16-1.93, p = 0.002). In subgroup analysis, elevated NSE did not predict worse OS in patients who received only chemotherapy (HR 1.22, 95% CI 0.96-1.55, p = 0.10) or part of whom received surgical resection before chemotherapy and radiotherapy (HR = 2.16, 95% CI 0.82-5.69, p = 0.12).
Elevated serum NSE before any therapy of SCLC patients may be a negative prognostic factor for OS and PFS. The prognostic value of NSE for OS was particularly observed in patients treated by standard management.
神经元特异性烯醇化酶（NSE）已成为一种广泛应用且易于获得的小细胞肺癌（SCLC）实验室检测方法。然而，NSE 对 SCLC 患者的预后价值仍存在争议。本研究旨在评估治疗前血清 NSE 升高与 SCLC 患者生存之间的相关性。
我们进行了系统评价和荟萃分析。在 PubMed、Embase 和 Cochrane 中央注册数据库中进行了系统的文献检索，检索时间从建库开始至 2019 年 12 月。根据纳入和排除标准纳入符合条件的文章，然后进行数据提取和质量评估。主要结局指标是总生存期（OS），次要结局指标是无进展生存期（PFS）。
我们共纳入 18 项研究，共 2981 例患者。汇总结果显示，NSE 升高与 OS 较差相关（HR=1.78，95%CI 1.55-2.06，p<0.001）和 PFS 较差相关（HR=1.50，95%CI 1.16-1.93，p=0.002）。亚组分析显示，NSE 升高并不能预测仅接受化疗的患者 OS 更差（HR 1.22，95%CI 0.96-1.55，p=0.10）或部分患者在化疗和放疗前接受手术切除的患者 OS 更差（HR=2.16，95%CI 0.82-5.69，p=0.12）。
SCLC 患者任何治疗前血清 NSE 升高可能是 OS 和 PFS 的负预后因素。NSE 对 OS 的预后价值在接受标准治疗的患者中尤为明显。
