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
Processing time: 80 Days and 22.6 Hours
ARTICLE HIGHLIGHTS
Research background

The diagnosis of silicosis is mainly based on occupational history, symptoms and imaging, among which imaging is the current gold standard. However, in some cases, chest X-ray examination cannot fully meet the clinical needs. There has been no ideal biomarker of silicosis until now.

Research motivation

Studies have found that elevated neuron-specific enolase (NSE) concentration in serum of silicosis patients was helpful for diagnosis and severity assessment of the disease. However, there were many deficiencies in these studies. Among them, the most important deficiency was insufficient sample size.

Research objectives

The purpose of this study was to investigate the clinical significance of serum NSE in diagnosis and staging of silicosis. We hypothesized that the serum NSE concentration of silicosis patients was higher than that of non-silicosis patients, and the serum NSE concentration of silicosis patients increased with the progression of disease stage.

Research methods

The study was carried out in strict accordance with the criteria of diagnostic tests. The required sample size was estimated according to the formula for diagnostic tests. In addition, many measures had been taken to control bias.

Research results

The results agreed with our hypothesis. 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, with sensitivity of 72% and specificity of 90%.

Research conclusions

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

Research perspectives

Subsequently, we hope to increase the sample size to further evaluate the role of serum NSE concentrations in the diagnosis of silicosis patients and determine the optimal cut-off value. We also hope to conduct further studies on the pathophysi-ological mechanism of elevated serum NSE concentration in silicosis patients.