neuronspecifik-enolase-nse (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>&nbsp;Neuronspecifik enolase bruges til kontrol af behandlingseffekt eller for recidiv af neuroendokrine tumorer (NET),&nbsp;<a href="~/link.aspx?_id=DA70B1EE64FD4845B8B6EA2925908EC5&amp;_z=z">sm&aring;cellet lungecancer&nbsp;</a>eller&nbsp;<a href="~/link.aspx?_id=A91144BCDDF74AB6B8A7D2EEFC5ED0DE&amp;_z=z">neuroblastom</a><a href="EditorPage.aspx?da=core&amp;id=%7B72A539A5-1C8E-40F7-BA61-F59E0FD92F89%7D&amp;ed=FIELD1074105295&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1074105715&amp;us=sitecore%5Claod&amp;mo&amp;pe=0&amp;fbd=1" title="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged S, Nissen PH|Lyngbyes laboratoriemedicin. 2 udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-value="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-type="book-reference">1</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7B72A539A5-1C8E-40F7-BA61-F59E0FD92F89%7D&amp;ed=FIELD7986730582&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H7986730648&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Isgrò MA, Bottoni P, Scatena R, Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects. Adv Exp Med Biol 2015;867: 125-43" data-value-piped="Isgrò MA, Bottoni P, Scatena R|Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects.|Adv Exp Med Biol|2015|867|125-43|26530364" data-url="reference-link" data-pubmedid="26530364" title="Isgrò MA, Bottoni P, Scatena R, Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects. Adv Exp Med Biol 2015;867: 125-43">2</a></li>
</ul>
<h2>Definition</h2>
<ul>
    <li>St&oslash;rstedelen af NeuronSpecifik Enolase (NSE) produceres&nbsp;i hjernens neuroner hos raske. Visse tumorer har&nbsp;neuroendokrin differentiering&nbsp;(sm&aring;cellet lungecancer,&nbsp;<a href="~/link.aspx?_id=F591CCE49F43450D9529B1595BEBC734&amp;_z=z">f&aelig;okromocytom</a>, neuroblastom) og&nbsp;producerer NSE, som&nbsp;derfor kan&nbsp;anvendes til kontrol af behandlingseffekt og observation af recidiv&nbsp;af sm&aring;cellet lungecancer og neuroblastom. Er en specialistopgave</li>
    <li>Bestemmelse af neuronspecifik enolase i serum, m&aring;lt i &micro;g/L&nbsp;</li>
</ul>
<h2>Indikationer</h2>
<ul>
    <li>Kontrol af behandlingseffekt og opsporing af recidiv ved sm&aring;cellet lungecancer og neuroblastom</li>
    <li>Evt. monitorering af seminom</li>
    <li>Evt. monitorering af malignt melanom</li>
    <li>Monitorering af hjerneskade
    <ul>
        <li>Hovedtraumer</li>
        <li><a href="~/link.aspx?_id=94012BB2FA994D54AB6E15EED95449BB&amp;_z=z">Apopleksi</a>&nbsp;</li>
    </ul>
    </li>
    <li>Ved organiske sygdomme i CNS kan der v&aelig;re indikation for at m&aring;le NSE i spinalv&aelig;ske</li>
</ul>
<h2>Fortolkninger<a href="%20" title="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged S, Nissen PH|Lyngbyes laboratoriemedicin. 2 udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-value="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-type="book-reference">1</a><sup>,</sup><a href="%20" title="Nilsson-Ehle P (red). Laurells Klinisk kemi i praktisk medicin. 9. udg.. Lund: Studentlitteratur; 2012" data-url="reference-link" data-value-piped="Nilsson-Ehle P (red)|Laurells Klinisk kemi i praktisk medicin. 9. udg.|Lund|Studentlitteratur|2012" data-value="Nilsson-Ehle P (red). Laurells Klinisk kemi i praktisk medicin. 9. udg.. Lund: Studentlitteratur; 2012" data-type="book-reference">3</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7B72A539A5-1C8E-40F7-BA61-F59E0FD92F89%7D&amp;ed=FIELD7986730582&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H7986730648&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Isgrò MA, Bottoni P, Scatena R, Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects. Adv Exp Med Biol 2015;867: 125-43" data-value-piped="Isgrò MA, Bottoni P, Scatena R|Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects.|Adv Exp Med Biol|2015|867|125-43|26530364" data-url="reference-link" data-pubmedid="26530364" title="Isgrò MA, Bottoni P, Scatena R, Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects. Adv Exp Med Biol 2015;867: 125-43">2</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Luo H, Shen K, Sun H, Li R, Wang Z, Xie Z, Correlation study between serum neuro-specific enolase and gastric and colorectal cancers. Medicine (Baltimore) 2020;99: e19796" data-value-piped="Luo H, Shen K, Sun H, Li R, Wang Z, Xie Z|Correlation study between serum neuro-specific enolase and gastric and colorectal cancers.|Medicine (Baltimore)|2020|99|e19796|32311993" data-url="reference-link" data-pubmedid="32311993" title="Luo H, Shen K, Sun H, Li R, Wang Z, Xie Z, Correlation study between serum neuro-specific enolase and gastric and colorectal cancers. Medicine (Baltimore) 2020;99: e19796">4</a></h2>
<ul>
    <li>Forh&oslash;jet NSE ses ved sm&aring;cellet lungecancer,&nbsp;<a href="~/link.aspx?_id=E00B8959F2354DC5A9B8FEEB8260458F&amp;_z=z">neuroendokrine tumorer</a>&nbsp;(NET) og neuroblastom, men sj&aelig;ldent ved andre cancerformer</li>
    <li>Forh&oslash;jet NSE ses ogs&aring; ved ikke-sm&aring;cellet lungecancer og&nbsp;<a href="~/link.aspx?_id=B028367721B54DE78B8870E26D986FA8&amp;_z=z">kronisk obstruktiv lungelidelse</a><a href="%20" title="Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G, Neuron-specific enolase and lung cancer. Am J Clin Oncol 2005;28: 586-90" data-url="reference-link" data-value-piped="Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G|Neuron-specific enolase and lung cancer|Am J Clin Oncol|2005|28|586-90" data-value="Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G, Neuron-specific enolase and lung cancer. Am J Clin Oncol 2005;28: 586-90" data-type="journal-reference">5</a>, men sensiviteten er v&aelig;sentlig lavere ved ikke-sm&aring;cellet lungecancer (38 %)<a href="%20" title="Poposka BI et al, Neuron specific enolase - selective marker for small-cell lung cancer. Radiol Oncol 2004;38: 21-6" data-url="reference-link" data-value-piped="Poposka BI et al|Neuron specific enolase - selective marker for small-cell lung cancer|Radiol Oncol|2004|38|21-6" data-value="Poposka BI et al, Neuron specific enolase - selective marker for small-cell lung cancer. Radiol Oncol 2004;38: 21-6" data-type="journal-reference">6</a></li>
    <li>Sensitiviteten ved tidlig sm&aring;cellet lungecancer er omkring 50-60 % stigende til 90 % ved avanceret cancer
    <ul>
        <li>Der er en sammenh&aelig;ng mellem NSE niveauet og tumorbyrden, antal metastaser og behandlingseffekt&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7B72A539A5-1C8E-40F7-BA61-F59E0FD92F89%7D&amp;ed=FIELD7986730582&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H7986730648&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Isgrò MA, Bottoni P, Scatena R, Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects. Adv Exp Med Biol 2015;867: 125-43" data-value-piped="Isgrò MA, Bottoni P, Scatena R|Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects.|Adv Exp Med Biol|2015|867|125-43|26530364" data-url="reference-link" data-pubmedid="26530364" title="Isgrò MA, Bottoni P, Scatena R, Neuron-Specific Enolase as a Biomarker: Biochemical and Clinical Aspects. Adv Exp Med Biol 2015;867: 125-43">2</a></li>
    </ul>
    </li>
    <li>Ved recidiv efter remission, hvor NSE har v&aelig;ret lav, ses en kraftig stigning
    <ul>
        <li>En stigning i NSE kan ses op til 5 m&aring;neder f&oslash;r kliniske tegn, recidiv eller metastasering</li>
    </ul>
    </li>
    <li>Sensitiviteten ved&nbsp;gastroenteropancreatisk NETs er 39-43 % med en specificitet p&aring; 65-73 % for at adskille NET fra nonendokrine tumourer&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7B72A539A5-1C8E-40F7-BA61-F59E0FD92F89%7D&amp;ed=FIELD9207350721&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H9207350955&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Hofland J, Zandee WT, de Herder WW, Role of biomarker tests for diagnosis of neuroendocrine tumours. Nat Rev Endocrinol 2018;14: 656-669" data-value-piped="Hofland J, Zandee WT, de Herder WW|Role of biomarker tests for diagnosis of neuroendocrine tumours.|Nat Rev Endocrinol|2018|14|656-669|30158549" data-url="reference-link" data-pubmedid="30158549" title="Hofland J, Zandee WT, de Herder WW, Role of biomarker tests for diagnosis of neuroendocrine tumours. Nat Rev Endocrinol 2018;14: 656-669">7</a></li>
    <li>Sensitiviteten ved neuroblastom omkring 60 % stigende til 90 % ved avanceret sygdom
    <ul>
        <li>H&oslash;je v&aelig;rdier er associeret med d&aring;rlig prognose</li>
    </ul>
    </li>
    <li>Kan ses forh&oslash;jet ved en mange sygdomme herunder en lang r&aelig;kke cancere: f&aelig;okromocytom, carcinoid, medull&aelig;r thyroideacarcinom, hepatocellul&aelig;rt carcinom, lymfom, seminom, malignt melanom, ventrikel og coloncancer, og nyrecancer</li>
    <li>Hovedtraumer med hjerneskade</li>
    <li>Apopleksi</li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)<a href="EditorPage.aspx?da=core&amp;id=%7B72A539A5-1C8E-40F7-BA61-F59E0FD92F89%7D&amp;ed=FIELD7986735049&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H7986735419&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Xie E, Zhang W, Xu H, Ling Y, Zhang Q, Pan S, Correction of serum NSE reference intervals includes the unidentified hemolysis sample: 1-year data analysis from healthcare individuals. J Clin Lab Anal 2019;33: e22997" data-value-piped="Xie E, Zhang W, Xu H, Ling Y, Zhang Q, Pan S|Correction of serum NSE reference intervals includes the unidentified hemolysis sample: 1-year data analysis from healthcare individuals.|J Clin Lab Anal|2019|33|e22997|31402486" data-url="reference-link" data-pubmedid="31402486" title="Xie E, Zhang W, Xu H, Ling Y, Zhang Q, Pan S, Correction of serum NSE reference intervals includes the unidentified hemolysis sample: 1-year data analysis from healthcare individuals. J Clin Lab Anal 2019;33: e22997">8</a></h2>
<ul>
    <li>Let h&aelig;molyseret pr&oslash;vemateriale giver forh&oslash;jede v&aelig;rdier</li>
    <li>Ved sv&aelig;rt lip&aelig;misk pr&oslash;vemateriale kan NSE ikke udf&oslash;res</li>
    <li>Forh&oslash;jede v&aelig;rdier ses ogs&aring; ved&nbsp;benigne lungesygdomme<a href="%20" title="Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G, Neuron-specific enolase and lung cancer. Am J Clin Oncol 2005;28: 586-90" data-url="reference-link" data-value-piped="Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G|Neuron-specific enolase and lung cancer|Am J Clin Oncol|2005|28|586-90" data-value="Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G, Neuron-specific enolase and lung cancer. Am J Clin Oncol 2005;28: 586-90" data-type="journal-reference">5</a></li>
</ul>
<h2>Biokemisk baggrund<a href="%20" title="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged S, Nissen PH|Lyngbyes laboratoriemedicin. 2 udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-value="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-type="book-reference">1</a></h2>
<ul>
    <li>NSE er en neuronspecifik endolase. Dannes som andre peptidhormoner i de neuroendokrine celler, som ligger spredt i organismens epitelv&aelig;v. Disse celler udg&oslash;r en mellemting mellem nervesystemet og det endokrine system </li>
    <li>Enolase er en dimer med to af tre subenheder &alpha;, &beta;, &gamma;</li>
    <li>NSE er det isoenzym (&gamma; &gamma;-enolase), som findes i store m&aelig;ngder i hjernen, is&aelig;r i neuronerne, og opfattes som en specifik mark&oslash;r for nerveceller </li>
    <li>Enolase er et Mg- og Mn- afh&aelig;ngig glycolytisk enzym, der katalyserer omdannelsen af 2 fosfoglycerat til fosfoenolpyruvat</li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Veneblodpr&oslash;ve
    <ul>
        <li>Serum - r&oslash;r uden antikoagulans - r&oslash;d prop med eller uden gel</li>
        <li>15 min. hvile</li>
    </ul>
    </li>
</ul>
<h3>Sm&aring;cellet lungecancer</h3>
<ul>
    <li>F&oslash;rste pr&oslash;ve tages f&oslash;r kemobehandling p&aring;begyndes</li>
    <li>Efterf&oslash;lgende pr&oslash;vetagninger efter protokol, interval afh&aelig;ngig af klinikken</li>
</ul>
<h2>Referenceintervaller<a href=" " data-type="journal-reference" data-value="Yang J, Tang A, Ma J, Sun X, Ming L, The reference intervals for CA125, CA15-3, CA19-9, CA72-4, AFP, CEA, NSE and CYFRA21-1. Scand J Clin Lab Invest 2019;79: 71-74" data-value-piped="Yang J, Tang A, Ma J, Sun X, Ming L|The reference intervals for CA125, CA15-3, CA19-9, CA72-4, AFP, CEA, NSE and CYFRA21-1.|Scand J Clin Lab Invest|2019|79|71-74|30727773" data-url="reference-link" data-pubmedid="30727773" title="Yang J, Tang A, Ma J, Sun X, Ming L, The reference intervals for CA125, CA15-3, CA19-9, CA72-4, AFP, CEA, NSE and CYFRA21-1. Scand J Clin Lab Invest 2019;79: 71-74">9</a>,<a href=" " data-type="journal-reference" data-value="Xie E, Zhang W, Xu H, Ling Y, Zhang Q, Pan S, Correction of serum NSE reference intervals includes the unidentified hemolysis sample: 1-year data analysis from healthcare individuals. J Clin Lab Anal 2019;33: e22997" data-value-piped="Xie E, Zhang W, Xu H, Ling Y, Zhang Q, Pan S|Correction of serum NSE reference intervals includes the unidentified hemolysis sample: 1-year data analysis from healthcare individuals.|J Clin Lab Anal|2019|33|e22997|31402486" data-url="reference-link" data-pubmedid="31402486" title="Xie E, Zhang W, Xu H, Ling Y, Zhang Q, Pan S, Correction of serum NSE reference intervals includes the unidentified hemolysis sample: 1-year data analysis from healthcare individuals. J Clin Lab Anal 2019;33: e22997">8</a></h2>
<h3>NSE</h3>
<ul>
    <li>&lt; 16,3 &micro;g/L</li>
    <li>Der kan v&aelig;re forskelle mellem laboratorier</li>
</ul>
<h2>Diagnostisk gr&aelig;nsev&aelig;rdi</h2>
<ul>
    <li>Der findes ikke alment accepterede diagnostiske gr&aelig;nsev&aelig;rdier</li>
    <li>Dog efter&nbsp;genoplivning af hjertestoppatienter: Vejledende er v&aelig;rdier &gt;60&micro;g/L mere end 48 timer efter genoplivning er st&aelig;rkt associeret med d&aring;rlig prognose, mens v&aelig;rdier &gt;100&micro;g/L utvetydigt indikerer d&aring;rlig prognose (h&aelig;molyse skal v&aelig;re udelukket)<a href="https://neuro.dk/wordpress/nnbv/hypoksisk-hjerneskade/">(link)</a></li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>NPU19868</li>
</ul>
<h3>Navne</h3>
<ul>
    <li><strong>Langt navn</strong>
    <ul>
        <li>P&mdash;Neuron-specifik enolase; massek. = ? &micro;g/L</li>
    </ul>
    </li>
    <li><strong>Kort navn</strong>
    <ul>
        <li>Neuron-specifik enolase;P</li>
    </ul>
    </li>
</ul>]]></HtmlField>
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