Prognostic significance of neuron-specific enolase in patients with diffuse large B-cell lymphoma treated with rituximab-based immunochemotherapy

Abstract

The present study examined the clinical significance of serum neuron-specific enolase (NSE) in patients with diffuse large B-cell lymphoma (DLBCL). Serum NSE values were measured using a electrochemiluminescence assay in 106 patients and tissue NSE expression was examined using immunohistochemistry in 65 patients. Fifty-four percent of patients had a positive expression of serum NSE (>15.20 ng/mL), and cytoplasmic NSE was pathologically demonstrated in 26/65 cases, which showed a positive correlation with that of serum NSE expression. The serum NSE value was closely correlated with performance status, serum lactate dehydrogenase (LDH) level, International Prognostic Index (IPI) score, and Ann Arbor stage, and declined significantly in patients who responded to treatment. In the rituximab-immunochemotherapy group, there was a significant difference in the 5-year overall survival (OS) rate between the NSE-positive and -negative groups (93% vs. 44%, p = 0.001), and the serum NSE level was found to be an independent prognostic factor. Serum NSE may be a novel marker of disease aggressiveness as well as a prognostic factor for DLBCL in the era of rituximab.

Keywords:

• Diffuse large B-cell lymphoma
• neuron-specific enolase
• overall survival
• rituximab
• immunochemotherapy

Acknowledgements

We would like to thank all of the treating physicians of the Cancer Center, Sun-Yat sen University for allowing us to include their patients. In addition, we greatly appreciate the cooperation of all the pathologists of the Cancer Center, Sun-Yat sen University for their support via the lymphoma pathology service. Our work was supported by the following funds: National Natural Science Foundation of China, contract/grant number 30471976; Science and Technology Projects of Guangdong Province, contract/grant numbers 2010B031600233 and 2010A09 0200019.

Potential conflict of interest: Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.