Published online Feb 16, 2021. doi: 10.12998/wjcc.v9.i5.1016
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
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.
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.
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.
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.
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%.
Serum NSE concentration may be a promising biomarker for diagnosis and assessment of severity of silicosis.
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.