Correction of the NSE concentration in hemolyzed serum samples improves its diagnostic accuracy in small-cell lung cancer

A.A.M. (Sylvia) Genet, E. Visser, Ben E.E.M. van den Borne, Maggy Youssef El Soud, Huub Belderbos, Gerben Stege, Marleen de Saegher, Federica Eduati, Maarten A.C. Broeren, Joost L.J. van Dongen, Luc Brunsveld, Daan H. van de Kerkhof (Corresponding author), Volkher Scharnhorst

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Samenvatting

Neuron-specific enolase (NSE) is a well-known biomarker for the diagnosis,
prognosis and treatment monitoring of small-cell lung cancer (SCLC). Nevertheless, its clinical applicability is limited since serum NSE levels are influenced by hemolysis, leading to falsely elevated results. Therefore, this study aimed to develop a hemolysis correction equation and evaluate its role in SCLC diagnostics.
Two serum pools were spiked with increasing amounts of hemolysate obtained
from multiple individuals. A hemolysis correction equation was obtained by analyzing the relationship between the measured NSE concentration and the degree of hemolysis. The equation was validated using intentionally hemolyzed serum samples, which showed that the correction was accurate for samples with an H-index up to 30 μmol/L. Correction of the measured NSE concentration in patients suspected of lung cancer caused an increase in AUC and a significantly lower cut-off value for SCLC detection when compared to uncorrected results.
Therefore, a hemolysis correction equation should be used to correct falsely
elevated NSE concentrations. Results of samples with an H-index above 30 μmol/L
should not be reported to clinicians. Application of the equation illustrates the
importance of hemolysis correction in SCLC diagnostics and questions the correctness of the currently used diagnostic cut-off value.
Originele taal-2Engels
Pagina's (van-tot)2660-2668
Aantal pagina's9
TijdschriftOncotarget
Volume11
Nummer van het tijdschrift27
DOI's
StatusGepubliceerd - 7 jul 2020

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