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Die Bestimmung der neuronspezifischen Enolase im Serum zur Therapiekontrolle beim metastasierten Seminom

  • R. Kuzmits
  • G. Schernthaner
  • K. Krisch
  • C. Kratzik
Conference paper

Zusammenfassung

Bei 110 Patienten mit malignen Hodentumoren wurde die neuronspezifische Enolase (NSE) im Serum bestimmt und mit den anerkannten Tumormarkern Alphafetoprotein (AFP) und humanem Choriongonadotropin (HCG) verglichen. Deutlich erhöhte NSE-Aktivitäten im Serum wurden bei 12/16 (75%) Patienten mit metastasiertem Seminom gemessen. Nach der Chemotherapie kam es zu einem Abfall der NSE-Konzentration bis in den Normbereich. Mittels immunhistochemischer Methoden konnte die NSE in Seminomzellen dargestellt werden.

Nur 6/40 (15%) der Patienten mit metastasierten nichtseminomatösen Hodentumoren zeigten erhöhte Serum NSE-Aktivitäten. AFP und HCG waren bei 70% der Patienten in dieser Gruppe erhöht, die Bestimmung der NSE ergab bei diesen Patienten keine zusätzliche Information.

Bei 53/54 Patienten, die nach der Orchiektomie keinerlei Hinweise für eine Metastasierung zeigten, lagen die Serum-NSE-Konzentrationen im Normbereich; nur bei einem Patienten wurde ein NSE-Wert an der oberen Grenze der Norm gemessen. Dies weist auf eine gute Spezifität der Bestimmung der NSE im Serum hin.

NSE ist ein neuer Marker für Seminome und kann von klinischem Wert bei der Therapiekontrolle und Verlaufsbeobachtung von Patienten mit metastasiertem Seminom sein.

Abstract

Neuron-specific enolase (NSE) was determined in serum from 110 patients with testicular cancer and compared to the established tumor markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Markedly increased serum NSE activity was measured in 12 of 16 (75%) patients with metastatic seminoma. After successful chemotherapy a fall in serum NSE activity to within the normal range was observed. Localization of NSE in seminoma cells could be demonstrated immunohistochemically.

Only six of 40 (15%) patients with metastatic nonseminomatous germ cell tumors showed increased serum NSE activity. Both AFP and HCG were elevated in 70% of patients, and determination of serum NSE activity gave no additional information in this patient group.

Of 54 patients after orchidectomy with no evidence of metastatic disease in a careful clinical examination, 53 showed serum NSE activity within the normal range; only in one patient was a borderline elevated serum NSE concentration found, indicating a high specificity of serum NSE. NSE ist a new marker for seminoma and is of clinical value in monitoring therapy in patients with metastatic seminoma.

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Literatur

  1. 1.
    Akoun GM, Scarna HM, Milleron BJ, Benichou MP, Herman DP (1985) Serum neuron specific enolase. A marker for disease extent and response to therapy for small cell lung cancer. Chest 87: 39–43PubMedCrossRefGoogle Scholar
  2. 2.
    Bosl GJ, Geller NL, Cirrincione C, Nisselbaum J, Vugrin D, Whitmore WF, Golbey RB (1983) Serum tumor markers in patients with metastatic germ cell tumors of the testes: A 10 year experience. Am J Med 75: 29–35PubMedCrossRefGoogle Scholar
  3. 3.
    Carney DN, Marangos PJ, Ihde DC, Bunn PA, Cohen MH, Minna JD, Gazdar AF (1982) Serum neuron-specific enolase: a marker for disease extent and response to therapy of small cell lung cancer. Lancet i: 583–586CrossRefGoogle Scholar
  4. 4.
    Cooper EH, Splinter TAW, Brown DA, Muers MF, Peake MD, Pearson SL (1985) Evaluation of a radioimmunoassay for neuron specific enolase in small cell lung cancer. Br J Cancer 52: 333–338PubMedCrossRefGoogle Scholar
  5. 5.
    DeBruijn HA, Sleijfer DT, Koops HS, Suurmeijer AJH, Marrink J, Ockhuizen T (1985) Significance of human chorionic gonadotropin, alpha-fetoprotein, and pregnancy-specific beta-1-glycoprotein in the detection of tumor relapse and partial remission in 126 patients with nonsemi-nomatous testicular germ cell tumors. Cancer 55: 829–835CrossRefGoogle Scholar
  6. 6.
    Einhorn LH, Donohue J (1977) Cis-diamminedichloroplatinum, vinblastine and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med 87: 293–298PubMedGoogle Scholar
  7. 7.
    Gerbitz KD, Summer J, Thallmer J (1984) Brain-specific proteins: solid-phase immunobioluminescence assay for neuronspecific enolase in human plasma. Clin Chem 30: 382–386PubMedGoogle Scholar
  8. 8.
    Haimoto H, Takahashi Y, Koshikawa T, Nagura H, Kato K (1985) Immunohistochemical localization of γ-enolase in normal human tissues other than nervous and neuroendocrine tissues. Lab Invest 52: 257–263PubMedGoogle Scholar
  9. 9.
    Horwich A, Tucker DF, Peckham MJ (1985) Placental alkaline phosphatase as a tumour marker in seminoma using the H17E2 monoclonal antibody assay. Br J Cancer 51: 625–629PubMedCrossRefGoogle Scholar
  10. 10.
    Javadpour N (1980) The role of biologic tumor markers in testicular cancer. Cancer 45: 1755–1761PubMedCrossRefGoogle Scholar
  11. 11.
    Javadpour N (1983) Multiple biochemical tumor markers in seminoma. A double blind study. Cancer 52: 887–889PubMedCrossRefGoogle Scholar
  12. 12.
    Krisch K, Buxbaum P, Horvat G, Krisch I, Neuhold N, Ulrich W, Srikanta S (1986) Mononuclear antibody HISL-19 as an immunocytochemical probe for neuroendocrine differentiation. Its application in diagnostic pathology. Am J Pathol 123: 100–108PubMedGoogle Scholar
  13. 13.
    Peckham MJ (1981) Investigation and staging: General aspects and staging classification. In: Peckham MJ (ed) The management of testicular tumours. pp 89–95. Edward Arnold, LondonGoogle Scholar
  14. 14.
    Prognostic factors in advanced nonseminomatous germ cell testicular tumours: results of a multicentre study. Report from the Medical Research Council Working Party on Testicular Tumours (1985) Lancet i: 8–11Google Scholar
  15. 15.
    Pugh RCB (1976) Testicular tumours — the panel classification. In: Pugh RCB (ed) Pathology of the testis. pp 144–146 Blackwell Scientific Publications, LondonGoogle Scholar
  16. 16.
    Sternberger LA (1979) Immunocytochemistry (2nd ed) John Wiley, New YorkGoogle Scholar
  17. 17.
    Tapia FJ, Polak JM, Barbosa AJA, Bloom SR, Marangos PJ, Dermody C, Pearse AGE (1981) Neuron-specific enolase is produced by neuroendocrine tumours. Lancet i: 808–811CrossRefGoogle Scholar
  18. 18.
    Zeltzer PM, Marangos PJ, Evans AE, Schneider SL (1986) Serum neuron-specific enolase in children with neuroblastoma. Relationship to stage and disease course. Cancer 57: 1230–1234PubMedCrossRefGoogle Scholar
  19. 19.
    Zeltzer PM, Marangos PJ, Parma AM, Sather H, Dalton A, Hammond D, Siegel SE, Seeger RC (1983) Raised neuron-specific enolase in serum of children with metastatic neuroblastoma. A report from the Children’s Cancer Study Group. Lancet i: 361–363CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • R. Kuzmits
  • G. Schernthaner
  • K. Krisch
  • C. Kratzik

There are no affiliations available

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