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Meta-Analysis
. 2020 May 30;18(1):116.
doi: 10.1186/s12957-020-01894-9.

Prognostic value of neuron-specific enolase for small cell lung cancer: a systematic review and meta-analysis

Zhoujunyi Tian  1 , Chaoyang Liang  1 , Zhenrong Zhang  1 , Huanshun Wen  1 , Hongxiang Feng  1 , Qianli Ma  1 , Deruo Liu  1 , Guangliang Qiang  2
Affiliations
Meta-Analysis

Prognostic value of neuron-specific enolase for small cell lung cancer: a systematic review and meta-analysis

Zhoujunyi Tian et al. World J Surg Oncol. .

Abstract

Background: Neuron-specific enolase (NSE) has become a widely used and easily attainable laboratory assay of small cell lung cancer (SCLC). However, the prognostic value of NSE for SCLC patients remains controversial. The aim of the study was to evaluate the correlation between elevated serum NSE before therapy and survival of SCLC patients.

Methods: We performed a systematic review and meta-analysis. A systematic literature search was conducted in PubMed, Embase, and the Cochrane Central Register from the inception dates to December 2019. Eligible articles were included according to inclusion and exclusion criteria; then, data extraction and quality assessment were performed. The primary outcome was overall survival (OS), and the secondary endpoint was progression-free survival (PFS).

Results: We identified 18 studies comprising 2981 patients. Pooled results revealed that elevated NSE was associated with worse OS (HR = 1.78, 95% CI 1.55-2.06, p < 0.001) and PFS (HR = 1.50, 95% CI 1.16-1.93, p = 0.002). In subgroup analysis, elevated NSE did not predict worse OS in patients who received only chemotherapy (HR 1.22, 95% CI 0.96-1.55, p = 0.10) or part of whom received surgical resection before chemotherapy and radiotherapy (HR = 2.16, 95% CI 0.82-5.69, p = 0.12).

Conclusion: Elevated serum NSE before any therapy of SCLC patients may be a negative prognostic factor for OS and PFS. The prognostic value of NSE for OS was particularly observed in patients treated by standard management.

Keywords: Meta-analysis; Neuron-specific enolase; Prognosis; Small cell lung cancer.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram for identification of eligible studies
Fig. 2
Fig. 2
Forest plots of hazard ratios (HRs) for overall survival according to pretreatment serum NSE in SCLC patients
Fig. 3
Fig. 3
Influence analysis plots of combined effect sizes when each study was excluded
Fig. 4
Fig. 4
Forest plots of hazard ratios (HRs) for progression-free survival according to pretreatment serum NSE in SCLC patients
Fig. 5
Fig. 5
Funnel plot after trim and fill method. The small circles on the plot refer to the 16 studies included in the meta-analysis for correlation between serum NSE and OS, while the small diamonds on the plot refer to the 5 hypothetic studies needed to trim the plot to make it symmetric
See this image and copyright information in PMC

References

    1. Bray Freddie, Ferlay Jacques, Soerjomataram Isabelle, Siegel Rebecca L., Torre Lindsey A., Jemal Ahmedin. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018;68(6):394–424. - PubMed
    1. Gazdar AF, Bunn PA, Minna JD. Small-cell lung cancer: what we know, what we need to know and the path forward. Nat Rev Cancer. 2017;17:725–737. - PubMed
    1. Micke P, Faldum A, Metz T, Beeh KM, Bittinger F, Hengstler JG, et al. Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer--what limits limited disease? Lung Cancer. 2002;37:271–276. - PubMed
    1. Jett JR, Schild SE, Kesler KA, Kalemkerian GP. Treatment of small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e400S–e419S. - PubMed
    1. Faivre C, El Cheikh R, Barbolosi D, Barlesi F. Mathematical optimisation of the cisplatin plus etoposide combination for managing extensive-stage small-cell lung cancer patients. Br J Cancer. 2017;116:344–348. - PMC - PubMed