MEASUREMENT OF THE SERUM TUMOR-MARKER NEURON-SPECIFIC ENOLASE IN PATIENTS WITH BENIGN PULMONARY-DISEASES

Serum concentrations of neuron-specific enolase (NSE) were measured in 135 patients with benign pulmonary diseases who also underwent a clin ical, laboratory, and radiologic evaluation. Eleven percent of the pat ients as a whole and 27.3% of those who were tuberculous had abnormal serum levels of NSE. Significant differences in NSE levels were observ ed among the six diagnostic groups evaluated (p = 0.002). Males had hi gher levels than females (p = 0.003), and patients infected with the h uman immunodeficiency virus (HIV) had higher NSE levels than those not infected (p = 0.0026). Patients with alveolar infiltrates or an inter stitial pattern on chest X-ray had higher NSE levels than those with n ormal radiographs (p = 0.003 and p = 0.01, respectively). In fact, onl y 3.6% of the patients with normal radiographs had above-normal levels of NSE. Direct damage to the neural or neuroendocrine lung cells or s ome degree of local hypoxia is likely to play a role in the increase i n NSE in these patients. The small number and degree of abnormal value s of NSE observed in this study make it unlikely that an underlying be nign lung disease will substantially modify the interpretation of an i ncreased NSE value in patients with lung cancer. However, care should be taken in interpreting a moderately abnormal NSE value in the cancer patient in the presence of lung infiltrates such as obstructive pneum onitis.