HIGH NEURON-SPECIFIC ENOLASE LEVELS IN BRONCHOALVEOLAR LAVAGE FLUID OF PATIENTS WITH LUNG-CARCINOMA - DIAGNOSTIC-VALUE, RELATION TO SERUM NEURON-SPECIFIC ENOLASE, AND STAGING

BACKGROUND. High levels of neuron specific enolase (NSE) have recently been described in the bronchoalveolar lavage (BAL) fluid of patients with lung carcinoma. Although its Value in serum has been extensively studied, its diagnostic value in BAL fluid in terms of sensitivity, sp ecificity, and predictive value have not been evaluated. In addition, its value in staging and relation to serum NSE are yet unknown. METHOD S. NSE levels were determined on the same day in the BAL fluid and the sera of two groups of patients: those with newly diagnosed lung carci noma and those with smoking related chronic obstructive pulmonary dise ase (COPD). Clinical TNM staging was also performed. Levels of NSE in BAL fluid were expressed as nanograms per 100 international units of l actate dehydrogenase. BAL fluid NSE levels of the two groups were comp ared with staging and serum NSE. RESULTS. A highly significant differe nce exists in BAL NSE in the two groups. For diagnostic purposes, the simultaneous measurements of serum NSE increases its sensitivity, but specificity remains unchanged. No correlation exists between BAL NSE a nd serum NSE, tumor size, nodal status, or the presence of metastases. BAL NSE is a better predictor of malignancy than serum NSE. CONCLUSIO N. BAL fluid measurements of NSE may have diagnostic value, specially if it is simultaneously measured in the serum. However, our study does not show any value for this technique in staging of lung carcinoma. A lso it has no correlation with serum NSE. Studies will have to be perf ormed to determine if BAL NSE can predict chemotherapeutic sensitivity . (C) 1996 American Cancer Society.