Prognostic Value of Serum Neuron Specific Enolase and Pentraxin-3 In Acute Pulmonary Embolism

INTRODUCTION: The aim of this study is to investigate whether serum neuron-specific enolase (NSE) and pentraxin-3 (PTX-3) values are effective in the diagnosis and prognosis of acute pulmonary embolism. In addition, in the light of significant results, we aimed to determine a cut-off value for NSE and PTX-3 in acute pulmonary embolism and to try to determine the sensitivity - specificity in the diagnosis of pulmonary embolism according to these values.
METHODS: In this prospective study, patients who applied to the Emergency Department of Manisa Celal Bayar University School of Medicine between September 2019 and January 2021 and were diagnosed with acute pulmonary embolism constituted the study group and healthy volunteers without any chronic disease or drug use constituted the control group. Serum NSE and PTX-3 values of the patient and control groups were compared. In addition, demographic data, vital signs, laboratory findings, PESI (pulmonary embolism severity index) scores and prognoses of the patients were investigated.
RESULTS: In this study 70 patients diagnosed with pulmonary embolism were included to the patient group. 36 (51.4%) of them were women and the mean age was 67.01 ± 14. 74 healthy volunteers were included to the control group; 45 of them (60.8%) were women and the mean age was 44.99 ± 12.85. In patient group the mean PTX-3 value of the was 1.753±1.91 ng/ml, the mean NSE value was 182.13±14.99 ng/ml. In control group, the mean PTX-3 value was 0.429±0.035 ng/ml, the mean NSE value was 166.51±5.14 ng/ml. While there was a statistical difference between two groups in terms of pentraxin-3 value, there was no difference in terms of NSE value. When the cut-off value of 1.115 ng/ml for serum pentraxin-3 in the ROC analysis in order to distunguish the patients with pulmonary embolism from the control group, sensitivity was found to be 58.6% and specificity to be 96%.
DISCUSSION AND CONCLUSION: In our study, we found that serum PTX-3 level is a powerful biomarker with high specificity in the diagnosis of acute pulmonary embolism and is positively associated with the severity and prognosis of the disease. Therefore, we believe that serum PTX-3 may be a guiding biomarker in the diagnosis and prognosis of acute pulmonary embolism in clinical practice.