The realities of our time with the presence of a huge amount of mutagenic substances in the atmosphere, a decrease in physical activity and an abundance of far from healthy products and habits lead to far from comforting forecasts regarding the development of oncological pathologies. And it is precisely in relation to this category of diseases that the detection of pathology in the early stages of its development significantly increases the patient's chances of combating it. For this, modern clinical medicine has developed special tools, namely the detection of tumor genetic markers in the blood . The article will present what the NSE tumor marker is, its features, what indicators indicate, what diseases it indicates.
Tumor markers
Markers in medicine are the marks in the patient’s blood, which are easily detected phenotypically and linked to certain manifestations of the genome. Oncomarkers are biological factors that characterize the presence of a clinical pathology and its course. With the help of their analysis, it becomes possible to track the effect of a particular therapy on the course of the disease.
Clinical diagnosticians divide tumor markers into:
- The main ones are high sensitivity markers with high specificity.
- Minor - markers that refine the picture when analyzing the presence of previous ones.
- Additional - more often used in the analysis of relapses and clarifying the course of the disease.
In addition, tumor markers are able to provide information about the location of the tumor. So, the presence of CA15-3 and CEA markers in the blood indicates the presence of a pathological process in the mammary glands, and CA19-9 - about pathology in the intestine. Detected NSE tumor marker shows that there are pathologies in the neuroendocrine system. Markers directly distinguish tumor formations and tissues adjacent to them.
Specific enzyme
NSE tumor marker (decoding - Neuron-specific enolase, neurospecific enolase) is a glycolytic protein that is involved in the process of glucose oxidation in cells and is present in the human body in three isoforms:
- The alpha form is present in many cells and different tissues.
- The beta form is found only in muscle striated tissue and in cardiomyocytes. It has no diagnostic value.
- The gamma form (the NSE tumor marker itself) is a neurospecific enolase that is found in high concentrations in the nervous tissue and in neoplasms formed by mutated nerve cells.
Neurospecific enolase exists in our body in the form of dimers (a combination of two forms). For diagnosis, alpha-gamma and gamma-gamma dimers are used, which are present in the blood during the proliferation of neuroendocrine cells.
In the presence of mutated tumor cells of a neuroendocrine nature, the synthesis of neurospecific enolase increases significantly. This enzyme is found in the nervous tissue of the brain, spinal cord, and peripheral nervous system, and an increase in the NSE tumor marker in the blood becomes a determining factor in the presence of a pathological process. But not always.
Improving performance without pathology
Relative indicators of the NSE tumor marker norm correspond to 16.3 nanograms per milliliter of blood. An increase in indicators to 20 -25 ng / ml may be associated with such conditions that do not have an oncological etiology:
- Septic shock.
- Injuries and hemorrhages in the brain and internal organs.
- Inflammatory pathologies of the lungs.
- Benign neoplasms in the nervous system.
- Cerebral ischemic stroke
- Disorders of the central nervous system in epilepsy.
- Chronic renal failure.
That is why when conducting tests, when the NSE tumor marker is increased, a second study is always prescribed.
When to get tested
The doctor will prescribe an analysis for the NSE tumor marker in the following conditions:
- If lung carcinoma is suspected. Symptoms: shortness of breath, blood in expectorant fluid, unmotivated weight loss, Cushing's syndrome.
- Suspicion of pheochromocytomas (adrenal gland tumors). Symptoms: hyperhidrosis, increased blood pressure, unstable emotional state.
- Suspicion of pathology in the thyroid gland, with the detection of nodes in it, thyrotoxicosis.
- If you suspect a neuroblastoma, the symptomatic manifestations of which are bone pain, lameness, and disorders of the gastrointestinal tract. This is a malignant undifferentiated pathology of the nervous tissue. The majority of patients with neuroblastoma are children under 5 years old.
NSE tumor marker elevated what does it mean
Neurospecific enolase is a fairly accurate tool in diagnosing the following oncopathologies:
- Malignant process in the lungs and bronchi. An increase in the enzyme in the blood is observed in 80% of patients, and its level depends on the severity of the pathology. Analysis on the NSE tumor marker is the only test today that provides evidence on the diagnosis and monitoring of the treatment of this type of cancer. This enzyme is most sensitive to the most aggressive form of lung cancer - small cell cancer, prone to numerous metastases.
- Undifferentiated oncopathology of the nervous tissue (neuroblastoma). The enzyme indices are directly dependent on the degree of tumor formation and the stage of cancer. An increase in indicators is found in 60% of patients.
- Seminoma (oncopathology of the reproductive system of men). Increased rates are observed in 73% of patients, they depend on the stage of the disease.
- In carcinomas and tumors of the gastrointestinal tract, an increase in this indicator was recorded in one third of patients. The marker is considered auxiliary. An increase in enolase during periods of remission indicates a relapse of the disease and metastasis of the primary malignant neoplasm.
Preparation and analysis
The material for research is venous blood, although cerebrospinal fluid, as well as pleural, cystic and ascitic fluids, can be used.
Specific training for the delivery of biomaterial is not required. However, depending on the research method, blood is donated either on an empty stomach or with a break from the last meal for at least 4 hours. This question should be clarified in the laboratory.
During the day before the test, the intake of heavy, spicy, smoked and fatty foods should be excluded. Alcohol should be completely ruled out. It is strictly forbidden to smoke on the day of delivery of the biomaterial. Drinking mode does not change.
Physical and emotional stress should be minimized. When taking medications that you can’t refuse, you must warn the doctor, which will be reflected on the referral form.
The study lasts several days. In case of urgency, the test can be done within 24 hours. Duration depends on the method of analysis and the specific medical institution.
Study Features
It should be borne in mind that in different laboratories the analysis is carried out by different methods (enzyme-linked immunosorbent or electrochemiluminescent), the abstract values of the indicators may vary. That is why they do not compare the results, but conduct a re-analysis in the same institution.
The reliability of the result depends on compliance with the research protocol. The main part in this - the separation of serum from the blood should occur no later than one hour from the moment of sampling. Analysis errors are offset by repeated tests and monitoring changes in the level of nonspecific enolase in the blood of a particular patient.
To increase the accuracy and reliability of this analysis, it is supplemented with analyzes for tumor markers CEA, Cyfra-21-1, CgA, TPA, CA 15-3, SCC, which diagnose non-small cell and squamous oncopathologies.
Interpretation of the result and its interpretation
The norm of the NSE tumor marker is up to 16.3 ng / ml, the lowered values do not have diagnostic value. The point of the pathology of malignant tumors is from 25 mg / l.
It should be remembered that the indicators of neurospecific enolase in the blood is not a diagnosis, but only a tool in the hands of a specialist. The final diagnosis can only be made by a specialist, taking into account all factors - medical history, examination and analysis.
Referral to the NSE tumor marker screening in children and adults is an opportunity for early diagnosis of the cancer process and a tool for monitoring therapy.
To summarize
Molecular genetic diagnostics, as a tool for clinical research, entered our life not so long ago. But its main advantage is non-invasiveness and rather high reliability.
Oncomarkers of various pathologies are able to identify specific biologically active substances in the early stages of the development of the disease. Namely, early diagnosis of cancer is the key to and prerequisite for its successful therapy and improvement of the patient's quality of life.
Another advantage of diagnosis based on tumor markers is the ability to monitor the quality of treatment. In the case of the development of a cancerous tumor, when there are many treatment options, it is control over its effectiveness that allows you to choose the best quality treatment for a particular patient.
Remember that preventing a disease is easier than curing it. Watch your health and the health of your loved ones.