Serum neuron specific enolase - Impact of storage and measuring method

Abstract

Background: Neuron specific enolase (NSE) is a recognized biomarker for assessment of neurological outcome after cardiac arrest, but its reliability has been questioned. Our aim was to investigate what influence storage of samples and choice of measuring methods may have on levels of NSE in peripheral blood. Methods: Two serum samples were drawn simultaneously from 51 hypothermia treated cardiac arrest patients. One sample (original sample) was analysed when collected, using the Diasorin-method (LIAISON®NSE, LNSE). The other sample was frozen, stored at -70°C (stored sample), and reanalysed in the same laboratory 4-7 years later using both the Diasorin method and a Roche-method (NSE Cobas e601, CNSE). In addition, a comparison of the two methods was performed on 29 fresh samples. Results: The paired NSE results in original and stored samples were not significantly different, using the LNSE-method. The two methods produced significantly different results (p < 0.0001) on the paired, stored samples, with the CNSE method yielding higher values than the LNSE-method in 96% of samples. The CNSE method resulted in 36% higher values on average. In the method comparison on fresh samples, the CNSE-method generated on average 15% higher values compared to the LNSE-method, and the difference between the paired results was significant (p < 0.0001). Conclusion: The CNSE method generated consistently higher NSE-values than the LNSE method and this difference was more pronounced when frozen samples were analysed. Tolerability for prolonged freezing was acceptable.