Endocrine Abstracts

Introduction: There is a clinical need to develop better biomarkers for the monitoring of patients with neuroendocrine tumours (NETs), including for patients with multiple endocrine neoplasia (MEN). Chromogranins are widely used, as are individual hormones for specific syndromes. Neurone specific enolase (NSE), however, is measured less commonly and its utility is debatable.

Aims: To assess the value of measuring NSE in the clinical management of patients seen in Endocrinology.

Methods: Our electronic hospital results reporting system was searched for all NSE results from between 1/3/2016 to 1/3/2021 with the following fields: patient name, ID, request reason, clinician, location and result. Incomplete data were collated manually. Clinic letters were then screened manually to determine if NSE results influenced clinical plans.

Results: 223 NSE reports were identified covering 103 patients (range 1-6 reports per patient). Most were performed on patients with MEN (142, 63.7%) or those undergoing investigation for MEN (17, 7.6%). 92.4% of NSE requests were from Endocrinology. It was not possible to analyse 33/223 samples due to haemolysis, sample processing errors or incorrect samples being received. 30/190 (15.8%) reports were abnormal, 6 being in patients with non-endocrine tumours. The remaining 24 reports covered 19 patients, 12 who had confirmed MEN. Abnormal NSE results ranged from 15.1-138.2µg/l, with all but 2 results being less than twice the upper limit of normal (15 & 16.3µg/l). NSE results, whether normal or abnormal, did not change the clinical management plan for any patient. In 2 patients where the NSE was especially high (>60µg/l), gastrin and chromogranins were also raised and were more clinically relevant, which influenced management.

Discussion: NSE does not seem to be a useful marker to measure in patients seen in our Endocrine Department. Reducing NSE test requests could result in time and cost savings without having an impact on patient care.