Journal Article

Prognostic value of neuron-specific enolase for small cell lung cancer: a systematic review and meta-analysis

Qiang, Guangliang, Ma, Qianli, Tian, Zhoujunyi, Zhang, Zhenrong, Wen, Huanshun, Feng, Hongxiang, Liu, Deruo, Liang, Chaoyang

2020

Overview

Background 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. Methods 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). Results 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). Conclusion 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.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Antigens / Biomarkers, Tumor - blood / Cancer therapies / Care and treatment / Cell adhesion & migration / Chemoradiotherapy, Adjuvant / Chemotherapy / Correlation analysis / Development and progression / Disease / Enolase / Enzyme regulation / Genetic aspects / Health aspects / Humans / Lung cancer / Lung Neoplasms - blood / Lung Neoplasms - mortality / Lung Neoplasms - therapy / Management / Medical prognosis / Medicine / Medicine & Public Health / Meta-analysis / Neuron-specific enolase / Phosphopyruvate hydratase / Phosphopyruvate Hydratase - blood / Pneumonectomy / Predictive Value of Tests / Prognosis / Progression-Free Survival / Quality assessment / Quality control / Radiation therapy / Risk Assessment - methods / Secondary data analysis / Small cell lung cancer / Small cell lung carcinoma / Small Cell Lung Carcinoma - blood / Small Cell Lung Carcinoma - mortality / Small Cell Lung Carcinoma - therapy / Studies / Subgroups / Surgical Oncology / Survival / Survival Rate / Systematic review