neuron-specific enolase
Summary
Neuron-specific enolase (NSE) is the gamma-gamma dimer of the glycolytic enzyme enolase, expressed in neurons and neuroendocrine cells. It serves as a serum and IHC marker for neuroendocrine tumors, particularly small cell lung carcinoma and neuroblastoma.
Detail
Enolase catalyzes the conversion of 2-phosphoglycerate to phosphoenolpyruvate in glycolysis; the gamma subunit (NSE) is selectively expressed in neurons and neuroendocrine cells. Elevated serum NSE is found in small cell lung carcinoma (useful for monitoring response and recurrence), neuroblastoma (where high levels correlate with worse prognosis along with N-myc amplification), medullary thyroid carcinoma, carcinoid, and pheochromocytoma. NSE is part of the standard neuroendocrine IHC panel (with chromogranin A, synaptophysin, and CD56). It is less specific than chromogranin/synaptophysin because some non-neuroendocrine tumors can express it. Boards classic: a child with abdominal mass crossing midline + elevated urinary HVA/VMA + high NSE = neuroblastoma.
Sources
- First Aid for USMLE Step 1 2024
- Robbins Basic Pathology 10th ed
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.