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Test Code NSE Neuron-Specific Enolase (NSE), Serum

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

A follow-up marker in patients with neuron-specific enolase-secreting tumors of any type

 

An auxiliary test in the diagnosis of small cell lung carcinoma

 

An auxiliary test in the diagnosis of carcinoids, islet cell tumors and neuroblastomas

 

An auxiliary tool in the assessment of comatose patients

Method Name

Homogeneous Time-Resolved Fluorescence

Reporting Name

Neuron Specific Enolase, S

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic screw-top aliquot tube

Specimen Volume: 0.5 mL


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 7 days
  Ambient  7 days

Reject Due To

Hemolysis

Mild reject; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

Mild reject; Gross reject

Other

NA

Reference Values

≤15 ng/mL

Serum markers are not specific for malignancy, and values may vary by method.

Interpretation

Serum neuron-specific enolase (NSE) measurement has its greatest utility in the follow-up of patients with tumors of any type that have been shown to secrete NSE. With successful treatment, serum concentrations should fall with a half-life of approximately 24 hours. Persistent NSE elevations in the absence of other possible causes (see Cautions) suggest persistent tumor. Rising levels indicate tumor spread, or in patients who had previously become NSE negative, recurrence.

 

In the context of a patient with a lung mass, disseminated malignancy of unknown origin or symptoms suggestive of paraneoplastic disease without identifiable tumor, elevated NSE suggests an underlying small cell lung carcinoma (SCLC).

 

In patients with suspected carcinoid, islet cell tumor, or neuroblastoma, who have no clear elevations in the primary tumor markers used to diagnose these conditions, an elevated serum NSE level supports the clinical suspicion.

-Carcinoid: chromogranin A, urinary 5-hydroxyindoleacetic acid, serum/blood 5-hydroxytryptamine

-Islet cell tumors: variety of peptide and amine-derived hormones, chromogranin A

-Neuroblastoma: vanillylmandelic acid and homovanillic acid

 

When considered alongside established outcome predictors of coma, such as Glasgow coma scale and other clinical predictors (papillary light responses, corneal reflexes, motor responses to pain, myoclonus, status epilepticus), electroencephalogram, sensory evoked potentials, measurement of serum NSE concentrations provides additional information. Elevated levels are indicative of a poor outcome. Currently, no established algorithms exist to combine serum NSE concentrations and the various other predictors into a composite score that gives clear predictive outcome information. The NSE measurement therefore needs to be considered in a qualitative or semi-quantitative fashion and carefully weighed against other predictors by a physician experienced in examining and managing coma patients.

Day(s) and Time(s) Performed

Monday through Saturday; 2:30 p.m.

Analytic Time

1 day

Specimen Retention Time

3 months

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

83520

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NSE Neuron Specific Enolase, S 15060-7

 

Result ID Test Result Name Result LOINC Value
NSE Neuron Specific Enolase, S 15060-7