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Vol. 30. Issue 8.
Pages 375-380 (October 1994)
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Vol. 30. Issue 8.
Pages 375-380 (October 1994)
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Utilidad de la enolasa neuroespecífica sérica en el manejo clínico del carcinoma microcítico de pulmón
Serum neuron specific enolase in the clinical management of small cell lung cancer
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J. Sánchez de Cos Escuín*,1, F. Masa Jiménez*, C. Disdier Vicente*, J.L. de la Cruz Ríos*, C. Vergara Fiordia*, C. Domínguez Retortillo**, F. Fuentes Otero***
* Unidad de Neumología. Hospital San Pedro de Alcántara. Cáceres
** Laboratorio de Bioquímica. Hospital San Pedro de Alcántara. Cáceres
*** Sección de Neumología. Hospital Infanta Cristina. Universidad de Extremadura. Badajoz
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Se analiza la utilidad de la enolasa neuroespecífica (NSE) sérica en el diagnóstico y manejo del carcinoma microcítico de pulmón (CMP).

Se efectuaron determinaciones séricas de NSE en 69 adultos sanos, 106 pacientes con neumopatías no neoplásicas (NNN), 26 con metástasis pulmonares de origen extrapulmonar (MPOE), 126 con carcinoma pulmonar no microcítico (CPNM) y 77 con CMP. En estos últimos, se realizaron determinaciones sucesivas durante y después del tratamiento y se registró el tiempo de supervivencia.

La NSE resultó elevada en el 77,6% de los CMP (50% en casos de enfermedad limitada [EL], y 93,6% en enfermedad extendida [EE]), en el 10,3% de los CPNM, en el 11,5% de MPOE y en el 2,8% de NNN.

La NSE descendió en el 100% de los CMP que obtuvieron remisión completa tras el tratamiento y en el 25% de los que no respondieron favorablemente. Posteriormente, el marcador ascendió en el 81,2% de las recidivas; en el 6,2%, dicho ascenso precedió a la sintomatología.

La concentración inicial de NSE demostró valor pronóstico (p = 0,003) independientemente del estadio (EL o EE).

La NSE es de gran valor diagnóstico y pronóstico en el CMP, refleja fielmente la masa tumoral, y los cambios postratamiento guardan estrecho paralelismo con el curso de la enfermedad.

The utility of neuron specific enolase (NSE) for the diagnosis and management of small cell lung cáncer (SCLC) is analyzed.

Serum concentrations of NSE were measured in 69 healthy adults, 106 patients with non-neoplastic pneumopathy (NNP), 16 with pulmonary metastasis of extra-pulmonary origin (PMEO), 126 with non-small cell lung cancer (NSCLC), and 77 with SCLC. Repeated analyses were carried out for patients in the last group during and after treatment, and survival time was recorded.

NSE was high in 77.6% of patients with SCLC [50% in cases with limited disease (LD) and 93.6% in those with extensive disease (ED)]. NSE was high in 10.3% of those with NSCLC, in 11.5% of those with PMEO, and in 2.8% of those with NNP. NSE decreased 100% in SCLC patients achieving full remission after treatment and in 25% of those responding poorly. Later, this marker increased in 81.2% of those experiencing relapse, and in 6.2% of these the increased preceded symptoms. Initial NSE concentrations had prognostic value (p = 0.003) that was independent of disease stage (LD or ED).

NSE is of great diagnostic and prognostic valué in SCLC, accurately reflecting tumor size. Posttreatment changes closely parallel disease activity.

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Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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