What does ESR show in oncology? Importance of blood test

ESR (erythrocyte sedimentation rate) is an important diagnostic indicator; it can indicate both a banal infection and oncopathology.

The normal value of this indicator depends on many factors: gender, age, physiological processes in the body. Its meaning can also change beyond the disease state, in completely healthy people, especially women. It is associated with the menstrual cycle, pregnancy and childbirth, as well as the postpartum condition.

Normal ESR values are considered:

Children 1-2 mm/h
Men 1-10 mm/h
Women 2-15 mm/h

How is ESR level related to cancer?

Erythrocyte sedimentation rate is a very practical indicator, since it is part of a general blood test, without which no medical examination is complete. This fact contributes to the early detection of the disease.

The ESR level most often increases during inflammatory diseases in the body, but if its value does not decrease after a course of anti-inflammatory therapy, it is necessary to be on alert for cancer.

Blood consists of plasma and formed elements (erythrocytes, platelets, leukocytes), the indicator shows the sedimentation rate of all formed elements, but the number of erythrocytes significantly exceeds all others, for this reason they are taken as the basis for the indicator.

The value depends on the ratio of proteins in the blood plasma; with an increase in the fraction of globulins, fibrinogens and a decrease in the amount of albumin, it increases. The protein is necessary for actively dividing cancer cells, the number of which increases exponentially. Also, the immune system, trying to overcome an unfamiliar formation, reduces the amount of protein in the blood.

Reasons for deviations

An abnormal ESR accompanies many diseases and is thus an atypical test for any pathology. An accelerated ESR basically always proves the existence of an organic disease. However, a correct ESR does not exclude the existence of even very serious diseases. The exact indicator that indicates pathology is determined by the doctor.

A high ESR in a patient who has no clinical signs of infection should suggest other investigations may be performed. Since there are many pathological processes that can determine an increase in ESR in women and men.

An elevated ESR may indicate a malfunction in the body that may raise suspicion of the diagnosis: values increase with anemia, infectious diseases, inflammatory conditions (for example, vasculitis) and tumor diseases, acute myocardial infarction, liver diseases.

C-reactive protein is an acute phase protein produced by the liver during an inflammatory response. Because C-reactive protein levels in the blood increase more quickly after the onset of an inflammatory or infectious process, ESR is often replaced by C-reactive protein measurement.

However, there are some limitations: for example, both ESR and CRP tests were independently associated with the diagnosis of acute maxillary sinusitis. In some cases, a combination of two measurements may improve sensitivity and diagnostic specificity. Several studies have examined the differential diagnostic values of ESR and CRP in inflammatory diseases and have concluded that ESR is a potentially relevant biomarker for disease differentiation.

ESR level in oncological diseases

With such a serious pathology, its value rises to enormous numbers, most often 70-80 mm/h. But it should be remembered: this indicator is not a specific tumor marker, and it is even more impossible to establish a diagnosis based on one indicator of a blood test. This finding can only prompt the doctor to think about further diagnostic search in a certain direction.

The above indicator should be considered in conjunction with clinical symptoms and the results of other tests and diagnostic procedures. A malignant process may be indicated by a simultaneous decrease in hemoglobin content to 70 g/l.

Serious deviations

Deviations from the norm can occur in many conditions and situations. This fact can lead to false positive test results and lead the attending physician on the wrong trail.

The reasons may be:

Vaccination against hepatitis B;
Administration of large amounts of heparin;
Anemic conditions;
Kidney failure;
Obesity, hypercholesterolemia;
Taking oral contraceptives;
Elderly age;
Violation of the rules of analysis.

All these reasons can lead to significant deviations in ESR.

Where to look for pathology?

Here the opinions of oncologists differ: many believe that the sedimentation rate increases only with certain types of tumors, while others say that it can be high for all types of tumors. One thing is clear - this is not a 100% indicator, since often this process occurs even with normal ESR values.

Most often it increases with the following types of formations:

Bowel cancer;
Mammary gland;
Ovaries;
Cervix;
Malignant lung disease;
Lymphatic system and bone marrow.

If we talk about a benign process, then most often it is localized in the intestine.

Benign tumor and ESR

As is known, in addition to malignant tumors, there are also benign tumors. They grow more slowly than malignant ones, or stop their growth altogether, but can put pressure on neighboring organs, disrupting their activity. Under certain conditions, benign tumors turn into malignant ones.

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At the same time, benign tumors also increase the erythrocyte sedimentation rate, which can cause unjustified anxiety for the patient, who will suspect he has cancer after learning about the results. It should be understood that a benign tumor can exist for decades and affect the ESR for decades without degenerating into a malignant tumor.

Analysis of ESR in cancer

It is a very important indicator because it is the first one to fall into the hands of a doctor. Neoplasms in the human body very often do not manifest themselves in any way at the initial stages of development, and this indicator can help in early diagnosis.

This test is routine and is performed in any hospital or clinic, this is its advantage. Diagnostics do not require any complex and expensive devices and reagents. Most often it is carried out using the Panchenkov method. It includes the following steps:

Capillary blood collection (from a finger) for research;
Place it in a graduated glass tube and add substances that prevent clotting;
It is installed vertically and after an hour the results are measured (red blood cells settle, forming a vertical column of red color, its value in mm is recorded).

REMEMBER! A high ESR does not mean anything; it is only a signal for the doctor that it is necessary to pay attention and conduct a diagnostic search.

Source: OnkologPro.ru

Is there a relationship between ESR levels and cancer?

The prevalence of cancer is steadily increasing every year. According to statistics, every year more than 5.5 million patients are diagnosed with cancer. A relationship has been identified between age and frequency of occurrence: every second patient with cancer is usually over 60 years of age.

Currently, the etiology of oncological pathologies, as well as treatment methods, remain an unresolved issue. At the same time, mortality from cancer ranks 3rd in the list of leading causes of death. This allows us to classify cancer as one of the most dangerous diseases, requiring the earliest possible diagnosis and adequate therapy.

How is it determined?

The most common is the Panchenkov method .

Its essence is that capillary blood is located inside a clean test tube (pipette) located vertically. Over time, the solid part of the blood (cells) forms a sediment, the height of which is measured by a specialist.

How the erythrocyte sedimentation rate is determined using the Panchenkov method is described in the video:

Normal values

The ESR level changes not only during pathological processes in the body. It depends on gender, age, what time of day the blood is taken for analysis and other factors.

Therefore, the analysis is carried out only under certain conditions, and then it is possible to judge whether the patient’s indicator corresponds to the norm.

Normal ESR values at different ages:

In children under 1 year - from 2 to 10 mm/h;
From 1 to 11 years - from 2 to 12 mm/h;
From 11 to 18 years - from 2 to 12 mm/h;
In adult women - from 2 to 15 mm/h;
In adult men - from 1 to 10 mm/h;
In men and women over 50 years of age - from 2 to 20 mm/h (maximum - 30 mm/h).

Attention! The norm increases in women during pregnancy to approximately 40 mm/h (starting from the 4th month).

Sometimes the norm for older people is set using a special formula: for men it is age divided by two, for women it is age + 10 divided by 2. These calculations are appropriate for people over 60 years old.

Cancer indicator table for men and women

ESR indicators in oncology are very different from the norm. So, if with other infectious and inflammatory processes it is possible to increase the sedimentation rate to 30 mm/h, then with cancer the rate increases several tens of times.

Indicators	Possible diagnosis
Women	80-100 mm/h	Cancer of the ovaries, cervix, mammary glands, lymph nodes, bone tissue, lungs
Men	70-80 mm/h	Cancer of the testicles, bone marrow, lungs, lymph nodes

ESR in oncology

The ESR rate in oncology increases sharply to critical values. The highest rates are observed with multiple myeloma (chronic leukemia of lymphocytes) and malignant granuloma (malignant neoplasms of lymph nodes), as well as with the spread of metastases from the primary site.

Patients often wonder why ESR in the blood increases during oncology? It has been established that increased aggregation of erythrocytes is facilitated by changes in the chemical composition of the blood. Thus, in cancer, there is an increase in the level of mutant proteins that are produced by abnormal cancer cells. And against the background of the inflammatory process in the human body, the concentration of specific acute-phase proteins increases. Thus, the erythrocyte sedimentation rate accelerates as a result of an excess amount of structural components of the blood.

How is ESR in the blood determined?

There are 3 methods for determining the criterion in question:

according to Panchenkov - the technique is implemented using special capillaries with 100 divisions and Na citrate (anticoagulant), which prevents the clotting of the blood being tested. After mixing capillary blood on a special concave glass with an anticoagulant, it is collected to the control mark on the capillary. Then placed in a vertical position on a tripod for 1 hour. The ESR value is determined by the height of the translucent column of blood serum above the settled cells. The disadvantage of the method is subjectivity in the assessment, the error of measuring divisions on the capillary, the maximum value is 100 mm/h;
according to Westergren (in vitro) - international standard. The test is carried out in test tubes with 200 divisions, the biomaterial is venous blood, which is mixed with an anticoagulant immediately after collection. After which the Westergren tubes are placed in a rack. The result is taken into account after 1 hour, units. measurements – mm/h. The advantage is the greater sensitivity of the technique compared to the Panchenkov test (the maximum value is increased to 200 mm/h);
The micromethod is implemented on a special analyzer TEST1 with a maximum of 200 mm/h.

Any public hospital provides the opportunity to determine the ESR value free of charge; in private clinics the price starts from 150 rubles. The analysis results must indicate the method used.

Normal values

Important: the value of reference (normal) values should be selected taking into account the gender and age of the patient.

The gradation of normal values is presented in the table.

Floor	Age	ESR norm, mm/h
Any	0 - 1 month	2-5
	1 – 6 months	5-15
	1 – 10 years	1-10
	10-15 years	2-15
Male	15 – 50 years	2-15
Male	More than 50 years	2-20
Female	15 – 50 years	2-15
Female	More than 50 years	2-20

It has been noted that in women the erythrocyte sedimentation rate may be higher than in men. This fact is due to a lower content of red blood cells, and therefore a higher rate of sedimentation.

Read further: What does CEA blood test mean, decoding and marker norm

Table of ESR indicators in oncology for men and women

Independent interpretation of results for self-diagnosis is unacceptable. All received data should be deciphered only by the attending physician. If, upon repeated analysis (after 1 day), consistently high values are recorded, then a large-scale screening examination of the patient is prescribed to make an accurate diagnosis.

Floor	ESR value, mm/h	Possible reason
Male	70-80	Cancer of the testicles, bone marrow, lungs, lymph nodes
Female	80-100	Cancer of the ovaries, cervix, mammary glands, lymph nodes, bone tissue, lungs

A critical level of ESR (ten times higher) in oncology in men and women indicates a late stage of the disease and the spread of metastases to neighboring organs.

Important: the ESR level during chemotherapy and after surgical removal of a malignant neoplasm should return to normal values.

The absence of positive dynamics indicates a relapse of the disease or the start of metastasis processes. At the therapy stage, monthly monitoring of the value in question is carried out in order to early identify the ineffectiveness of the chosen treatment tactics.

How the research is carried out

The ESR indicator in the blood in oncology is calculated according to the following rules:

blood is taken from a vein;
use an anticoagulant solution to mix;
place the composition in a special glass vessel and hold it vertically.

The rate of cell sedimentation is determined over 1 hour.

To get an accurate result you need to prepare:

test tubes;
anticoagulant;
sodium citrate.

The anticoagulant and blood should be mixed quickly. Each person has a different erythrocyte sedimentation rate. In elderly and senile people from 69 to 94 years old, the index is 110 mm/h. A clinical blood test to establish a nonspecific symptom is carried out according to Panchenkov’s method in 5 stages:

Take a 5% solution of sodium citrate for work and place it on a special glass.
Treat the capillary with this solution prepared in advance.
The material to be examined is collected into a clean vessel and transferred to glass.
Combine it with citrate and fill the capillary.
Then place it on a tripod and turn on the timer.

Important information: What does increased lymphocytes in the blood mean in an adult (causes and consequences)

To determine the result, the height of the clear liquid column is measured after 60 minutes.

Does an elevated ESR always indicate cancer?

The answer to this question from patients is definitely no. Possible reasons for exceeding reference ESR values other than oncology:

acute infectious process in the patient’s body, most often of a bacterial nature;
chronic inflammation;
diseases that significantly reduce the strength of the immune system (HIV, chronic hepatitis);
autoimmune diseases;
anemia - along with a drop in hemoglobin levels;
connective tissue pathologies (lupus, vasculitis, arthritis);
violation of blood clotting processes;
necrosis of organ tissue as a result of insufficient blood supply;
mechanical injuries;
intoxication of the body;
3-4 degree burns;
amyloid dystrophy, which is characterized by excessive accumulation of amyloid.

However, exceeding the upper limit of normal does not always indicate a disease. Certain medications (salicylates), menstruation and pregnancy can also increase red blood cell clumping. It is necessary to carry out control measurements after discontinuation of the drug, at least after 3 days.

How to properly prepare for research?

Main article: What does high erythrocyte sedimentation rate mean?

The accuracy of the results obtained directly depends on the correct preparation of the patient for blood donation. List of recommendations:

Donate blood strictly on an empty stomach, with your last meal at least 8 hours before the procedure;
Strict exclusion of alcoholic beverages for 1 day is mandatory;
stop any medications 1 day in advance in agreement with your doctor, if not possible, notify the laboratory about the medications you are taking;
You are allowed to drink clean, unsweetened water without gas;
30 minutes before collecting biomaterial, avoid physical and emotional stress, and also prohibit smoking.

How to prepare for a general blood test

Proper preparation for the test:

Capillary blood should be taken for analysis on an empty stomach or after a light breakfast.
The day before, you need to exclude fatty foods, alcohol, nicotine, and drugs that affect blood clotting, as they can distort ESR readings.
It is not recommended to donate blood after an X-ray examination.
It is advisable to take tests only in one laboratory (if possible, with one laboratory assistant), so that the results are more reliable and the dynamics can be monitored.
It is not recommended to drink strong tea and coffee in the morning, as they cause vasospasm and make it difficult to draw blood.

Summarizing

It is necessary to emphasize:

the value of ESR in cancer of the ovaries, bone tissue, lymph nodes and other organs deviates significantly from the norm. The more severe the stage of the disease, the higher the recorded rates;
a test to determine the erythrocyte sedimentation rate is the least specific, since deviations from the norm can provoke various physiological processes in the human body and pathologies, including cancer;
in rare cases, a healthy person has a consistently high ESR concentration;
finding the value under consideration within the normal range does not exclude the risk of developing cancer pathology in the patient. If cancer is suspected, it is necessary to undergo a comprehensive laboratory (panel of 20 tumor markers, general blood and urine analysis) and instrumental examination (MRI, CT, ultrasound). The final diagnosis is determined based on the totality of all available data in the patient’s medical history.

Read further: What blood test indicators show oncology (cancer)

Source: medseen.ru

Norm

Norms for erythrocyte sedimentation rate can vary greatly among different categories of people. There is a clear relationship between ESR and age, ESR and gender. Let's consider the erythrocyte sedimentation rate in individuals of various categories.

Table 1. Erythrocyte sedimentation rate in individuals of various categories.

Category of persons	ESR
Newborn babies	2-5 mm/hour
From a month to six months	12-17 mm/hour
Children from six months to one year	4-10 mm/hour
Children from one to ten years old	1-10 mm/hour
Teenagers 11-18 years old	2-12 mm/hour
Adult men	1-10 mm/hour
Adult women	2-15 mm/hour
Old men	Up to 30 mm/hour

As you can see, the ESR rate can vary greatly depending on the age and gender of a person. Another reason that can accelerate the erythrocyte sedimentation rate is pregnancy. The fact is that during pregnancy, the content of proteins that enter the blood plasma changes in the blood, and this leads to the fact that red blood cells begin to settle faster.

Noticeable changes begin only in the fourth month, and increase towards the ninth.

Thus, if in the first trimester the speed is about 15 mm/hour, in the second – 25, and in the third – already forty.

What analysis determines the rules for submission?

Erythrocyte sedimentation rate is measured in the laboratory by adding a reagent to the blood plasma.
Calculation of the rate of deposition of red formed elements is carried out using Panchenkov. This is the most cost-effective and fastest way. There are also Westergren and Wintrobe techniques, which are used less frequently. In the laboratory there are special devices designed to measure the speed of bonding of shaped elements. To do this, you need to take blood from your finger and 5% Na citrate. The components are mixed in a ratio of 1:4 and the process is monitored for 1 hour. After this time, the height of the column of red blood cell accumulation is determined. This is the ESR value.

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Preparing for the study

The erythrocyte sedimentation rate may be elevated in healthy people because it is sensitive to external and internal environmental factors. To minimize deviations, you must adhere to the following rules:

It is better to donate blood in the morning or in the first half of the day on an empty stomach.
The dinner before the diagnostic event should be low-calorie and light.
3 days before the procedure, it is better to avoid fatty, fried foods and alcohol.
You should not smoke 3 hours before the test.
It is not recommended to engage in heavy physical work 3 days before donating blood.
It is necessary to cancel physiotherapeutic procedures the day before the examination.

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Normal indicators

There is no single ESR level that indicates normal. It is different for adults and children, so you need to know the limits of the indicator for different categories of the population:

Age and gender	Norm (mm/hour)
Infants up to 6 months	2—5
Children 6-12 months	4—10
Teenagers 11-18 years old	2—12
Women	2—15
Men	1—10

During the period of bearing a child, indicators deviate from the norm, which is associated with restructuring of the body.
In women during pregnancy, ESR almost always increases and this is not considered a pathology. The reason for this phenomenon is radical changes in hormonal levels, activation of the cardiovascular and hematopoietic systems. The erythrocyte sedimentation rate in this category of the population should not exceed 30 mm/hour.

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OAC for oncology

ESR for cancer is detected in a general blood test, which is included in the standard set of tests upon admission to hospital treatment, if infectious diseases are suspected. When a tumor develops, the following results are revealed:

a drop in the number of red blood cells below 3.5 thousand in 1 μl of blood;
increase in leukocytes over 9,000/1 μl;
decrease in hemoglobin to 80-100 g/l;
acceleration of erythrocyte sedimentation to 70-80 mm/hour.

The journal “Modern Oncology” published the results of a study confirming the absence of changes in ESR in the blood during oncology in 16-38% of examined patients with cancer. This information confirms the need for additional diagnostics even with normal laboratory values.

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Blood biochemistry

For tests, it is necessary to take blood from a vein from the patient, the study of which will show whether there are any disturbances in the protein ratio.
In studies of venous material, indicators indicating oncology are also identified:

increased amount of C-reactive protein;
increase in alkaline phosphatase concentration;
violation of the ratio between proteins and a decrease in the total fraction;
increase in sugar if there is a tumor in the pancreas.

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What blood indicators indicate cancer?

In order to speak with a high degree of probability about oncological pathology, you need to monitor the levels of hemoglobin, the number of white blood cells (leukocytes), and the dynamics of ESR.

Normal ESR:

in women it ranges from eight units to sixteen mm/h;
in men from four to fourteen mm/h.

It would not be superfluous to take blood biochemistry tests for oncology, which can also promptly inform about a developing disease.

Important! An increase in readings of more than 70–75 mm/h indicates a high likelihood of cancer. Therefore, the person requires further examination.