What is NSE?
The abbreviation NSE stands for “neuron-specific enolase” or “neuron-specific enolase”. Enolases are enzymes that play an important role in sugar metabolism.
NSE is a version of the enolase enzyme that is mainly found in nerve cells and in so-called neuroendocrine cells. Neuroendocrine cells are special nerve cells that release hormones or other secretions in response to signals from other nerve cells.
When is the NSE value determined?
Doctors determine the NSE value as a tumor marker in various cancers, but also in patients with brain damage. The measured value is suitable for assessing the course of the disease, the success of therapy and the prognosis of patients.
What is the normal value for NSE?
An NSE concentration of less than 19.5 micrograms per liter (µg/l) of blood is considered normal. Sometimes medical laboratories use a different unit of measurement, namely nanograms per milliliter (ng/ml). The following applies: 1 µg/l = 1 ng/ml.
If the NSE reading exceeds the limit, the test is considered positive (otherwise negative). There are many reasons for a positive NSE test (i.e. elevated NSE values).
The standard range depends on the method. Different laboratories can therefore give slightly different normal values for NSE.
When is the NSE value elevated?
As a rule, the NSE value therefore increases in cancers that arise from cells of the nervous tissue and in the destruction of cells that contain NSE. As many cells produce NSE, the value is relatively unspecific. In medicine, it is therefore only used to support the diagnosis of diseases that are often associated with elevated NSE values. These include
Lung cancer
In one subtype of lung cancer, small cell lung cancer, elevated NSE values are often found. This is due to the fact that the cells of this tumor have a neuroendocrine origin. This is why increased NSE is measured in around 75 percent of patients with symptoms.
As small cell lung cancer usually only causes high NSE values late in the course of the disease, the laboratory value is not suitable as a tumor marker for diagnosing lung cancer. Instead, doctors can use the development of the measured value to assess the course of the disease.
Medulloblastoma
Medulloblastoma is the most common tumor of the central nervous system in children. It often releases NSE. Doctors measure its value for prognosis and progression assessment after diagnosis.
Seminoma
The two laboratory values hCG and NSE are useful in the diagnosis of seminoma. These are malignant tumors that often develop in the testicles (testicular cancer). They have a good chance of being cured.
Other malignant diseases
Thyroid cancer, kidney cancer and breast cancer can also increase NSE levels.
Stroke and traumatic brain injury
When large amounts of nerve tissue perish, the NSE value rises. The NSE value is therefore increasingly being measured to assess the prognosis for strokes or traumatic brain injury.
Other benign diseases
The NSE can be elevated in bronchopneumonia. This is a form of pneumonia. Pulmonary fibrosis (increased connective tissue formation in the lungs) and liver diseases are also associated with NSE increases.
Falsely high values due to blood samples
NSE is also contained in red blood cells (erythrocytes) and blood platelets (thrombocytes). Blood samples taken using the wrong technique and long storage times destroy these cells. This results in falsely high NSE values.
The same applies to patients in whom the breakdown of erythrocytes is increased due to a disease or genetic predisposition (haemolysis).
When is the NSE value too low?
A deviation downwards is not medically significant. Diseases that are often associated with high NSE values cannot be ruled out if the measured values are low.
