Serum neuron-specific enolase (NSE) is associated with the overall survival of colorectal cancer: a retrospective study

PeerJ. 2024 Nov 22:12:e18617. doi: 10.7717/peerj.18617. eCollection 2024.

Abstract

Background: Serum neuron-specific enolase (NSE) had been associated with survival of several cancers. However, its prognostic significance for colorectal cancer (CRC) has not been effectively discussed. We aimed to investigate the relationship between baseline serum NSE and the overall survival (OS) of colorectal adenocarcinoma (CRAD) patients.

Methods: A retrospective study had been conducted by including 564 histopathology confirmed CRAD patients between January 2013 and December 2018 from Yunnan Provincial Cancer hospital, China. Cox proportional hazards model was used to estimate the crude and adjusted associations between serum NSE measured at diagnosis and the OS of the patients. Restricted cubic spline (RCS) was further applied to delineate dose-response trend of the NSE-OS association.

Results: After controlling for possible confounding factors, baseline serum NSE was significantly associated with OS in CRAD: when dichotomizing by the median, patients with higher baseline serum NSE (NSE >= 12.93 ng/mL) were observed a worse prognosis (hazard ratio, HR: 1.82, 95% CI [1.30-2.55], p < 0.01). Stratified analysis by tumor stage revealed a stronger NSE-OS association in advanced CRAD patients. RCS disclosed a prominent dose-response relationship in NSE-OS association for all CRAD patients: along with the increase of baseline serum NSE, the adjusted HR of CRAD patients increased gradually. This dose-response trend is also evident in advanced stage CRAD patients, but not in early stage CRAD patients.

Conclusions: Serum NSE measured at diagnosis might be a useful prognostic indicator for CRAD, especially for advanced stage patients.

Keywords: Colorectal adenocarcinoma (CRAD); Neuron-specific enolase (NSE); Overall survival (OS); Prognosis; Survival analysis.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Aged
  • Biomarkers, Tumor* / blood
  • China / epidemiology
  • Colorectal Neoplasms* / blood
  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Phosphopyruvate Hydratase* / blood
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies

Substances

  • Phosphopyruvate Hydratase
  • Biomarkers, Tumor

Grants and funding

This study was supported by the Basic Research Program of Yunnan (202201AT070200), First-Class Discipline Team of Kunming Medical University (2024XKTDTS16), and the Scientific Research Fund Project of Yunnan Provincial Department of Education (2023Y0798; 2024Y212). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.