Plasma cell labeling index (PCLI) is a upon representative of plasma cell DNA synthesis and reflects the progression state of myeloma, and it is an important indicator of prognosis of patients with MM [11]. We speculate that, similar to PCLI, NSE does not primarily reflect the overall myeloma cell load but dynamically reflects the proliferation of myeloma cells. Therefore, NSE levels may become a new prognostic indicator. Importantly, since detection of NSE is simple and relatively inexpensive, NSE may be a more valuable clinical application than PCLI and can be incorporated into the routine examination of neoplastic diseases. Consistent with previous studies, we found that the level of NSE was significantly higher in patients with untreated small cell lung cancer.
It is widely agreed that the NSE level is a reliable indicator for the differential diagnosis of small cell lung cancer and a useful measure for the monitoring of the therapeutic efficacy of radiotherapy and chemotherapy [12]�C[15]. For diagnosis of neuroblastoma, sensitivity of NSE measurements can be up to 90% and have also been used to monitor treatment efficacy and relapse [16]. Increased NSE expression has also been linked to a small number of tumor cell lines, including non-small cell lung cancers, medullary thyroid carcinoma, and pheochromocytoma [17]. Several studies have found that NSE can be used as a sensitive and specific indicator for brain damage, and increases in NSE reflect the size and severity of brain damage [18]�C[19].
An increase in NSE has been found in cerebral ischemia and neuronal injury due to a variety of reasons, such as neonatal asphyxia, pediatric febrile seizures, brain infectious diseases, chronic obstructive pulmonary disease, cerebral infarction, cerebral hemorrhage, systemic lupus erythematosus, Wilson’s degeneration, and depression. Bai et al. reported that the NSE levels in patients with lymphoma were significantly increased [20]. In addition, increased NSE was seen in patients with extramedullary hemolysis, such as autoimmune hemolytic anemia and paroxysmal nocturnal hemoglobinuria, and can be used as a diagnostic indicator to distinguish in situ and extramedullary hemolysis [21]. However, even though there was a multitude of research regarding NSE levels in numerous types of cancer and other disease, there was little data available in the Chinese literature regarding NSE levels in MM.
One study by Zhang et al. [5] reported that MM patients with increased NSE levels had shorter overall survival, less progression-free survival, and a poorer prognosis than those with normal NSE levels. Consistent with this report, we observed in our study Drug_discovery that the PFS of patients with elevated NSE levels was significantly shorter than patients with normal levels of NSE.