Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2021; 9(5): 1016-1025
Published online Feb 16, 2021. doi: 10.12998/wjcc.v9.i5.1016
Serum neuron-specific enolase: A promising biomarker of silicosis
Hong-Bo Huang, Jun-Ling Huang, Xiao-Ting Xu, Kun-Bo Huang, Yi-Jian Lin, Jie-Bin Lin, Xi-Bin Zhuang
Hong-Bo Huang, Jun-Ling Huang, Xiao-Ting Xu, Yi-Jian Lin, Xi-Bin Zhuang, Department of Pulmonary and Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, Fujian Province, China
Kun-Bo Huang, Department of Clinical Laboratory, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, Fujian Province, China
Jie-Bin Lin, Department of Internal Medicine, Infectious Disease Hospital of Quanzhou, Quanzhou 362000, Fujian Province, China
Author contributions: Huang HB, Huang JL, Xu XT, Huang KB, Lin YJ, and Lin JB performed the experiments and wrote the manuscript; Zhuang XB designed the study and corrected the manuscript.
Supported by Quanzhou Science and Technology Bureau, No. 2018N053S.
Institutional review board statement: The study was approved by the Ethics Committee of Quanzhou First Hospital affiliated to Fujian Medical University.
Informed consent statement: All participants gave signed informed consent.
Conflict-of-interest statement: All the authors declare that there is no conflict of interest.
Data sharing statement: No additional data.
STROBE statement: The manuscript was revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Ling Huang, MD, Attending Doctor, Department of Pulmonary and Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 East Street, Quanzhou 362000, Fujian Province, China. 236992065@qq.com
Received: November 10, 2020
Peer-review started: November 10, 2020
First decision: November 29, 2020
Revised: December 12, 2020
Accepted: December 23, 2020
Article in press: December 23, 2020
Published online: February 16, 2021
Abstract
BACKGROUND

Silicosis is a type of chronic pulmonary fibrosis caused by long-term inhalation of silica dust particles. There has been no ideal biomarker for the diagnosis and differential diagnosis of silicosis until now. Studies have found that elevated neuron-specific enolase (NSE) concentration in the serum of silicosis patients is helpful for diagnosis and severity assessment of the disease. However, the number of cases in these studies was not enough to arouse attention.

AIM

To investigate the clinical significance of serum NSE in the diagnosis and staging of silicosis.

METHODS

From January 2017 to June 2019, 326 cases of silicosis confirmed in Quanzhou First Hospital Affiliated to Fujian Medical University were included in the silicosis group. A total of 328 healthy individuals or medical patients without silicosis were included in the control group. Serum NSE concentrations of all subjects were determined by electrochemical luminescence.

RESULTS

There were no significant differences in sex, age, smoking index and complications between the silicosis and control groups. The mean serum NSE concentration was 26.57 ± 20.95 ng/mL in the silicosis group and 12.42 ± 2.68 ng/mL in the control group. The difference between the two groups was significant (U = 15187, P = 0.000). Among the 326 patients with silicosis, 103 had stage I silicosis, and the mean serum NSE concentration was 15.55 ± 6.23 ng/mL. The mean serum NSE concentration was 21.85 ± 12.05 ng/mL in 70 patients with stage II silicosis. The mean serum NSE concentration was 36.14 ± 25.72 ng/mL in 153 patients with stage III silicosis. Kruskal–Wallis H test suggested that the difference in serum NSE concentration in silicosis patients in the three groups was significant (H = 130.196, P = 0.000). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.858 (95% confidence interval: 0.828-0.888; P = 0.000). When the NSE concentration was 15.82 ng/mL, the Jorden index was the largest, the sensitivity was 72%, and the specificity was 90%.

CONCLUSION

Serum NSE concentration may be a promising biomarker for the diagnosis and assessment of severity of silicosis.

Keywords: Silicosis, Neuron-specific enolase, Receiver operating characteristic curve, Disease stage, Biomarker, Diagnosis

Core Tip: The purpose of this study was to investigate the clinical significance of serum neuron-specific enolase (NSE) in the diagnosis and staging of silicosis. The results showed that the serum NSE concentration of silicosis patients was significantly higher than that of non-silicosis patients. With the progression of silicosis, NSE concentration increased gradually. The receiver operating characteristic curve suggested that when the diagnostic threshold of NSE was 15.82 ng/mL, the area under the curve was 0.858 (P = 0.000), with sensitivity of 72% and specificity of 90%. To the best of our knowledge, this study is the largest study on silicosis biomarkers to date.