Elevated ESR in oncology. Blood after chemotherapy. Video - Increased ESR

Laboratory research methods occupy an important place in the diagnosis of cancer. ESR in oncology can increase tenfold and makes it possible to suspect a malignant process and carry out additional measures. The study contributes to early diagnosis, which is positively reflected in the further treatment of the patient. In order to correctly interpret the results of the examination, you need to know the indicators of the norm, changes and conditions that can increase the erythrocyte sedimentation rate.

Indications for analysis

• suspected cancer;
• chemotherapy and radiation;
• acute infectious diseases;
• violation of the synthesis of red blood cells;
• congenital pathologies of the hematopoietic system.

Upon admission to the hospital, all patients undergo a blood test, including ESR.

What analysis determines the rules for surrender

The calculation of the rate of deposition of red shaped elements is carried out using Panchenkov. This is the most cost effective and fastest way. There are also methods of Westergren and Wintrob, which are used less frequently. In the laboratory, there are special devices designed to measure the speed of gluing shaped elements. To do this, take blood from a 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 accumulation of erythrocytes is determined. This is the meaning of ESR.

Study preparation

The erythrocyte sedimentation rate can be increased in healthy people, since it is sensitive to external and internal environmental factors. To minimize deviations, it is necessary to adhere to the following rules:

• It is better to donate blood in the morning or in the morning on an empty stomach.
• Dinner before the diagnostic event should be low-calorie and light.
• 3 days before the procedure, it is better to refuse fatty, fried foods and alcohol.
• Do not smoke 3 hours before the study.
• It is not recommended to engage in heavy physical work 3 days before donating blood.
• It is necessary to cancel physiotherapy procedures the day before the examination.

Normal performance

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

In women during pregnancy, ESR almost always rises and that is not considered a pathology. The reason for this phenomenon is the cardinal restructuring of the hormonal background, the activation of the activity of the cardiovascular and hematopoietic systems. The erythrocyte sedimentation rate in this category of the population should not exceed 30 mm/hour.

KLA in oncology

ESR in cancer is detected in a general blood test, which is included in the standard set of studies upon admission to inpatient treatment, with suspicion of infectious diseases. With the development of neoplasms, 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 up 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 in oncology in 16-38% of the examined patients with cancer. These data confirm the need for additional diagnostics even with normal laboratory parameters.

Biochemistry of blood

In studies of venous material, indicators indicating oncology are also distinguished:

• increased amount of C-reactive protein;
• an increase in the concentration of alkaline phosphatase;
• violation of the ratio between proteins and a decrease in the total fraction;
• increase in sugar, if a neoplasm in the pancreas.

The erythrocyte sedimentation rate (ESR) changes significantly in the presence of oncology, which allows it to be detected in advance. Usually this indicator is determined during a clinical blood test.

How much does ESR change in oncology and why does this happen?

Oncological pathology (cancer) is characterized by the appearance of foreign cells due to a failure in the genetic material and the formation of a malignant or benign tumor.

A malignant neoplasm has aggressive properties, is characterized by rapid cell reproduction, germination in tissues, and the ability to metastasize (daughter foci of neoplasm).

In tumor cells, the metabolism has significant differences; they synthesize a number of proteins that enter the bloodstream and change its physico-colloidal properties.

This leads to the fact that the ESR in cancer changes significantly - it becomes higher than the norm by 50-70 mm per hour or more.

A change in the indicator often occurs with the development of the following tumors:

• Pancreatic cancer, which is usually accompanied by a violation of the outflow of juice, followed by the development of pancreatic necrosis.
• A malignant neoplasm of the mammary gland, it is more often recorded in young women (about 40 years old).
• Thyroid cancer, which has a relatively benign course.
• Tumors localized in the structures of the gastrointestinal tract (esophagus, stomach, intestines) and leading to a violation of the functional state of the digestive system.
• Lung cancer, which is significantly more common in smokers over the age of 45.
• Oncology of the genitourinary system, neoplasm of the kidneys, cancer of the uterus, ovary in women, malignant tumor of the testicles, prostate in men. All diseases usually develop in relatively young people.
• Basalioma of the skin, melanoma (an aggressive tumor that develops from a mole, pathology provokes systematic long-term exposure to ultraviolet rays).
• Various brain tumors originating from neurocytes or accessory cells.
• Acute leukemia is a tumor process that affects the blood with a sharp violation of the functional state of the red bone marrow. Chronic leukemias develop from more differentiated cells and therefore have a relatively benign course.
• Cancer of the adrenal glands.
• Malignant neoplasm in the liver.

The development of most benign neoplasms is not accompanied by changes in the ESR value. However, with erythremia (a benign pathology of the blood, in which the content of red blood cells and hemoglobin levels increase), there is a sharp decrease in the indicator.

Important! A high ESR that exceeds the norm is not always a sign of oncological pathology. It also changes in a number of infectious, endocrine diseases, after the use of certain medications. Therefore, for an accurate diagnosis of cancer according to indications determined by an oncologist, additional (clarifying) studies are prescribed, which include modern instrumental imaging techniques. These include CT, MRI, and ultrasound.

ESR norms depending on gender and age

ESR is a diagnostic criterion that can be influenced by age and gender. An adult has a stable indicator, normally it remains the same, only with age the settling rate increases.

Normal indicators are presented in the table:

Preparation for analysis

In order to get a reliable result of the study, it is very important to properly prepare for it.

To do this, follow a few simple recommendations:

• The analysis is given only on an empty stomach (all studies are scheduled in the morning).
• Dinner on the eve of blood donation is allowed no later than 4 hours before the intended sleep, while fried, fatty foods and alcohol are excluded.
• In the case of taking medications, it is imperative to warn the attending physician about this, who will determine the need to cancel the medication before donating blood.
• On the day of the study, the intake of all drinks (especially tea, coffee), except for water, as well as physical or emotional stress that increase or decrease almost all indicators of a clinical blood test (increased ESR, leukocytosis may be the result of the body's physiological response to stress) is excluded.

How is the measurement carried out?

Determination of the erythrocyte sedimentation rate refers to laboratory studies.

It is usually performed during clinical analysis or after venous blood sampling for biochemical profiling.

Today, in the laboratories of medical clinics, the determination of ESR is performed using 2 methods - according to and.

According to Westergren

With this technique, blood is taken from the cubital vein. It is introduced into a special graduated test tube that contains an anticoagulant (a compound that prevents blood clotting, sodium citrate is usually used in laboratories).

After thorough mixing of venous blood and anticoagulant, the tube is left in a vertical position for 1 hour. Then, using a scale, the laboratory assistant evaluates the height of the plasma column, which shows the rate (the term reaction was previously used - ROE) of erythrocyte sedimentation.

According to Panchenkov

Unlike the previous technique, blood is taken from a finger (capillary blood), which is pierced with a special scarifier.

Mixing with an anticoagulant is carried out in a test tube, after which blood is drawn into a special graduated glass capillary and placed in a tripod for an hour. Then the laboratory assistant evaluates the height of the plasma column above the settled erythrocytes on a scale. The result is displayed in units of mm/h.

Important! If you have an increase in ESR - do not panic. Even in the case of an established diagnosis of oncological pathology, in the early stages, the prognosis for human life remains favorable.

The effectiveness of cancer therapy depends on the timely detection of changes before the appearance of metastases in the lymph nodes or distant organs and tissues.

The patient may not even guess about the malignant neoplasm that has arisen in the body for a long time. As a rule, this "terrible" pathology at first develops asymptomatically, and this is its insidiousness. The presence of a malignant tumor and its progression are evidenced by changes in the blood test, including deviations from the norm of the ESR indicator.

Permissible erythrocyte sedimentation rates

The rate of erythrocyte sedimentation in the blood normally depends not only on the gender of the patient, but also on age. Its deviations in the direction of decrease or increase indicate the processes of disharmony in the body, not necessarily in the direction of the disease. In particular, it can be hormonal disruptions, menstrual cycles in women, pregnancy, the postpartum period.

The established norms for the level of erythrocyte sedimentation are:

• in babies in the first six months of life - at least 2 mm / h, and not more than 5 mm / h;
• in babies in the second six months of life - at least 4 mm / h, and not more than 10 mm / h;
• in children from one to 11 years old - within 2-12 mm / h;
• in adolescents from 11 to 18 years old - within 2-12 mm / h;
• women - not lower than 2 mm / h, and not higher than 15 mm / h;
• men - not lower than 1 mm / h, and not higher than 10 mm / h.

An increased erythrocyte sedimentation rate is considered a cause for concern if it rises significantly in comparison with the established norms.

A slight increase in the ESR in women, as a rule, does not alarm specialists, since it directly depends on the state of hormonal metabolism, which is often disturbed while taking hormonal contraceptives, during menopause, during pregnancy.

The main reasons for "sounding the alarm"

An increased ESR can be considered a sign of many diseases of an inflammatory and chronic nature, while the clinical picture of the blood has an altered composition in other parameters. In particular, ESR in oncology increases markedly against the background of an equally noticeable decrease in the amount of hemoglobin.

Experts can suspect the occurrence and development of a malignant neoplasm in the body in the case of:

• a sharp deviation of the ESR norm towards an increase of up to 70 mm / h or more;
• the absence of a decrease in the rate of sedimentation of red blood cells against the background of anti-inflammatory drug therapy;
• decrease in hemoglobin levels in the blood to 70-80 units.

ESR rises already at the first "asymptomatic" stage of cancer, so often this analysis helps to timely identify cancerous pathology and take therapeutic measures in time.

Where to look for pathology

The changed level of the clinical indicator of the erythrocyte sedimentation rate in the blood prompts specialists to search for an acute inflammatory pathology in the body. If it cannot be detected, then there is a reason for suspicion of cancerous pathologies. As a rule, high ESR values ​​are diagnosed:

• with bowel cancer;
• oncology of the breast;
• cancer of the bone marrow;
• malignant neoplasm in the cervix;
• cancerous pathologies of the lymphatic system;
• ovarian cancer in women;
• lung cancer;
• benign neoplasms of the intestine.

By themselves, indicators of the rate of sedimentation of red blood cells are not one hundred percent evidence of oncological pathology, and more often it is used to track the dynamics of the progression of the tumor process in cancer.

An important aid for early diagnosis

Since the analysis involves the determination of many indicators, its decoding helps answer a number of important diagnostic questions:

1. What is the level of erythrocyte sedimentation rate.
2. How many platelets and leukocytes is determined by the clinical picture of the analysis.
3. What is the quantitative composition of hemoglobin and how much it deviates from the norm.

Their ratio helps to determine the place of possible localization of tumor pathology:

• with an intestinal tumor, the ESR can reach a critical value - up to 60-70 mm / h, and the hemoglobin level at the same time critically decreases sometimes to 60 units;
• high rates are recorded in lung cancer, but this formidable pathology can only be suspected against the background of an altered pattern of platelets and leukocytes;
• bowel oncology leaves the picture of the leukocyte formula practically unchanged.

Basic analysis for the presence of pathology

Despite the high degree of informativeness of the general analysis of blood composition, doctors are not recommended to focus only on these data when making a diagnosis. Some very serious pathologies do not fit into the clinical scheme and are difficult to diagnose using tests:

1. Peripheral lung tumors are almost asymptomatic, while the level of ESR may increase slightly. It reaches a critical value only when the disease passes into the terminal stage.
2. Right sided bowel tumors. Against the background of a slight increase in ESR, a strong drop in hemoglobin levels can be diagnosed against the background of mildly erased symptoms of intestinal disorders.

If the patient has an established oncological diagnosis, an analysis of the ESR content will help to effectively monitor the dynamics of the tumor process and help to understand in time whether the drugs for tumor therapy are selected correctly. Control is especially important in oncology of the lungs and intestines, since there is a risk of the tumor moving into a latent stage.

With constant monitoring of the erythrocyte sedimentation rate, the doctor gets the opportunity to control the dynamics of the tumor process: with inhibition of growth and progression of cancer, its indicators decrease, and during the period of exacerbation they increase sharply.

It is important to pay attention to the fact that high rates of erythrocyte sedimentation do not indicate the mandatory development of the tumor process. Even if all three components converge in the analysis - ESR, hemoglobin, leukocyte formula - this will only serve as a reason for a detailed additional study.

Ordinary healthy cells of the human body divide quite slowly, so they are not so susceptible to inhibition by cytostatics - drugs for chemotherapy.

But this does not apply to bone marrow cells that have a hematopoietic function. They divide as rapidly as malignant cells, and therefore are destroyed by therapy due to the rapid rate of division.

Chemotherapy has serious side effects for the human hematopoietic system. The blood of the patient after the course of chemotherapy sharply becomes poorer in its composition. This condition of the patient is called myelosuppression or pancytopenia - a sharp decrease in the blood of all its elements due to impaired hematopoietic function. This applies to the level of leukocytes, platelets, erythrocytes and so on in the blood plasma.

Through the blood flow, chemotherapy drugs spread throughout the body and at their end points - the foci of malignant tumors - have a devastating effect on cancer cells. But the blood elements themselves, which become damaged, are exposed to the same effect.

ESR after chemotherapy

ESR is an indicator of the rate of erythrocyte sedimentation in the blood, which can be determined during a general blood test. In deciphering the data on the state of the patient's blood, the last digit will indicate the level of ESR.

The analysis is carried out as follows: a substance is added to the blood that prevents its clotting, and the test tube is left in an upright position for an hour. Gravity forces the erythrocytes to settle to the bottom of the tube. After that, the height of the blood plasma of a transparent yellow color, which was formed within an hour, is measured - it no longer contains red blood cells.

After chemotherapy, the patient's ESR is increased, since a reduced number of red blood cells is observed in the blood, which is due to damage to the patient's hematopoietic system and pronounced anemia.

Lymphocytes after chemotherapy

Lymphocytes are one of the groups of leukocytes and serve to recognize agents harmful to the body and neutralize them. They are produced in the human bone marrow, and actively function in the lymphoid tissue.

The patient's condition after chemotherapy is characterized by the so-called lymphopenia, which is expressed in a decrease in lymphocytes in the blood. With an increase in the dose of chemotherapy, the number of lymphocytes in the blood drops dramatically. At the same time, the patient's immunity also deteriorates, which makes the patient unprotected to infectious diseases.

Leukocytes after chemotherapy

Leukocytes are white blood cells, which include cells of different appearance and functions - lymphocytes, monocytes, neutrophils, eosinophils, basophils. First of all, in the human body, leukocytes represent a protective function against pathogenic agents that are of external or internal origin. Therefore, the work of leukocytes is directly related to the level of human immunity and the state of the protective capabilities of his body.

The level of leukocytes in the blood after the course of chemotherapy was sharply reduced. This condition is dangerous for the human body as a whole, since the patient's immunity falls, and the person becomes exposed to even the simplest infections and harmful microorganisms. The resistance of the patient's body is greatly reduced, which can provoke a sharp deterioration in health.

Therefore, a necessary measure after undergoing chemotherapy is to increase the level of leukocytes in the blood.

Platelets after chemotherapy

After a course of chemotherapy in the patient's blood, there is a sharp decrease in the number of platelets, which is called thrombocytopenia. This condition of the blood after the transferred treatment is dangerous for the health of the patient, since platelets affect blood clotting.

The use of dactinomycin, mutamivin, and nitrosourea derivatives in chemotherapy has a very strong effect on platelets.

A decrease in the number of platelets in the blood is manifested in the appearance of bruises on the skin, bleeding from the mucous membranes of the nose, gums, and digestive tract.

Treatment of thrombocytopenia is selected depending on the severity of the disease. Low and medium degree of the disease does not require special treatment. But a severe degree of the disease, life-threatening, requires the use of a platelet transfusion. With a reduced level of platelets in the blood, the next course of chemotherapy may be delayed or the doses of drugs may be reduced.

To increase the level of platelets in the blood, you need to resort to certain measures:

1. Etamzilat or dicynone are drugs that increase blood clotting without affecting the number of platelets. They are available both in tablets and in solutions for injection.
2. Derinat is a drug based on salmon nucleic acids, available in drops or injections.
3. Methyluracil is a drug that improves trophism in the tissues of the human body and helps to accelerate regeneration processes.
4. Prednisolone is a drug that is used simultaneously with chemotherapy.
5. Sodecor is a medicinal product created on the basis of a mixture of herbal infusions. It is used in the treatment of respiratory diseases. At the same time, it is truly the most effective drug for increasing platelet levels. Literally, "before our eyes" - in three to four days of using the drug, the number of platelets returns to normal.
6. It is necessary to take B vitamins, vitamin C, calcium, magnesium and zinc preparations, lysine.
7. The use of nucleic-containing products for food - red caviar, nuts (hazelnuts, walnuts and pine nuts, almonds), seeds, legumes, sesame and flax seeds, sprouted grains of cereals, fresh seedlings of legumes, berries and fruits containing small grains - strawberries, strawberries , figs, blackberries, raspberries, kiwi. Any greens in large quantities are also useful, as well as spices - coriander, cloves, saffron.

Hemoglobin after chemotherapy

The consequences of chemotherapy is the inhibition of hematopoiesis, that is, the function of hematopoiesis, which also applies to the production of red blood cells. The patient has erythrocytopenia, which manifests itself in a low number of red blood cells in the blood, as well as a drop in hemoglobin levels, as a result of which anemia develops.

The level of hemoglobin in the blood becomes critical, especially after repeated courses of chemotherapy, as well as with a combination of chemotherapy and radiation therapy.

An increase in hemoglobin levels after a course of chemotherapy means an increase in the chances of patients to recover. Since the level of hemoglobin in the blood directly affects the survival of cancer patients.

Anemia after chemotherapy

Anemia is a sharp decrease in the number of red blood cells - erythrocytes, as well as hemoglobin - a protein found in erythrocytes. All cancer patients have mild or moderate anemia after undergoing chemotherapy. Some patients experience severe anemia.

As mentioned above, the cause of anemia is the inhibition of the functioning of the hematopoietic organs, damage to blood cells, which negatively affects the blood formula and its composition.

Anemia symptoms are:

• the appearance of pale skin and dark circles under the eyes;
• the appearance of weakness throughout the body and increased fatigue;
• the occurrence of shortness of breath;
• the presence of a strong heartbeat or its interruptions - tachycardia.

Anemia in cancer patients after chemotherapy can last for years, which requires the adoption of effective measures for its treatment. Mild and moderate anemia does not require enhanced therapy - it is enough to change the diet and take drugs that improve blood composition. In severe anemia, it is necessary to resort to a blood or red blood cell transfusion, as well as other measures. This was discussed in detail in the sections on increasing the level of red blood cells and hemoglobin.

ALT after chemotherapy

ALT - alanine aminotransferase - is a special protein (enzyme), which is located inside the cells of the human body, involved in the exchange of amino acids that make up proteins. ALT is present in the cells of certain organs: in the liver, kidneys, muscles, heart (in the myocardium - the heart muscle) and pancreas.

AST - aspartate aminotransferase - is a special protein (enzyme), which is also located inside the cells of certain organs - the liver, heart (in the myocardium), muscles, nerve fibers; in a smaller amount it contains the lungs, kidneys and pancreas.

Elevated levels of ALT and AST in the blood indicate the presence of a moderate or high degree of damage to the organ containing this protein. After a course of chemotherapy, there is an increase in the amount of liver enzymes - ALT and AST - in the blood serum. These changes in the results of laboratory tests mean, first of all, toxic damage to the liver.

Chemotherapy drugs have a depressing effect not only on the bone marrow, but also on other hematopoietic organs - the spleen and so on. And the larger the dose of drugs, the more noticeable the results of damage to internal organs become, and the function of hematopoiesis is more strongly inhibited.

How to increase white blood cells after chemotherapy?

Cancer patients often ask themselves: how to increase white blood cells after chemotherapy?

There are several common ways, which include:

1. Taking drugs Granatsit and Neupogen, related to drugs with a strong effect; the drug Leukogen, which has an average level of exposure; drugs Imunofal and Polyoxidonium, which have a gentle effect on the body. Also shown are preparations of granulocyte growth factors - Filgrastim and Lenograstim, which help stimulate the production of leukocytes in the bone marrow. At the same time, it should be remembered that only a doctor can prescribe the appropriate treatment.
2. Changes in the diet that require the inclusion of chicken and beef broths, mussels, stewed and baked fish, vegetables - beets, carrots, pumpkins, zucchini in the patient's diet.
3. The use of red fish and caviar is recommended, as well as in small quantities of natural red wine. All fruits, vegetables and red berries are useful.
4. It is useful to eat buckwheat with kefir for breakfast, which is prepared as follows. In the evening, the required amount of cereal is poured with water, in the morning kefir is added to it and the dish can be eaten.
5. Honey has useful qualities, it must be eaten twice a day before meals in an amount of forty to sixty grams per day.
6. It is good to use sprouted chicory and lentils - a tablespoon twice a day.
7. The walnut tincture will also help raise your white blood cell count. Peeled nuts are placed in a glass jar and filled with water. After that, the mixture is infused in the light, but not in direct sunlight, for two weeks, and then transferred to a dark place. You need to take the tincture three times a day, one tablespoon for at least a month.
8. From drinks it is recommended to take a decoction of barley, which is prepared from one and a half glasses of grain, boiled in two liters of water. The liquid is brought to a boil and then simmered until reduced by half. The decoction is drunk half an hour before meals three times a day for fifty milliliters. You can add a little honey or sea salt to it for goodness and taste.
9. A decoction of oats is also good for this purpose. A small saucepan is half filled with washed grain, then filled with milk to the top of the container and brought to a boil. After that, the broth is cooked on a steam bath for twenty minutes. It is taken in small amounts several times a day.
10. Five tablespoons of rose hips are crushed and filled with water in the amount of one liter. The drink is brought to a boil and simmered over low heat for another ten minutes. After that, the broth is wrapped and infused for eight hours. Taken throughout the day as a tea.
11. The patient needs to consume a large amount of liquid, which contains many vitamins. Freshly prepared juice, fruit drink, compote, green tea are recommended.

How to increase hemoglobin after chemotherapy?

Patients after a course of chemotherapy are puzzled by the question: how to increase hemoglobin after chemotherapy?

You can increase your hemoglobin level in the following ways:

1. A certain diet, which must be agreed with the attending physician. The nutrition of the patient should include substances that normalize the composition of the blood, namely: iron, folic acid, vitamin B12, and so on. At the same time, it is necessary to take into account the fact that the excess content of these components in food can lead to accelerated reproduction of malignant cells. Therefore, the nutrition of a cancer patient should be balanced, and the above elements are prescribed by the attending physician in the form of medicines.
2. If the hemoglobin level has fallen below 80 g / l, then the specialist prescribes the procedure for transfusion of red blood cells.
3. You can prevent a sharp drop in hemoglobin levels by transfusing whole blood or red blood cells before chemotherapy. Such a measure is necessary and immediately after the end of the course of treatment. But it must be taken into account that frequent blood transfusions (or its components) lead to sensitization of the patient's body, which subsequently manifests itself in the occurrence of allergic reactions after the blood transfusion procedure.
4. Effectively increases the level of hemoglobin erythropoietin. These drugs stimulate the development of red blood cells, which affects the acceleration of hemoglobin production (provided that the body has all the substances necessary for this). With the help of erythropoietins, an effect is exerted directly on the bone marrow in a selective manner. The results of the action of the drugs become noticeable some time after the start of its use, so it is advisable to prescribe them immediately after the detection of anemia. These medicines are expensive, among them Eprex and Neorecormon are considered affordable for our patients.
5. You can use a special "tasty" mixture, which is prepared as follows. Walnuts, dried apricots, raisins, prunes, figs and lemon are taken in equal parts. Everything is carefully crushed in a blender and seasoned with honey. This "medicine" is taken one tablespoon three times a day. The mixture is stored in a glass jar with a lid in the refrigerator.
6. The use of greens, especially parsley, garlic, boiled beef and liver, has a good effect on hemoglobin levels.
7. From freshly prepared juices, pomegranate, beetroot, radish juice are good.
8. It is necessary to use mixtures of fresh juices: beet-carrot (one hundred grams of each juice); apple juice (half a cup), beetroot juice (a quarter cup), carrot juice (a quarter cup) - taken twice a day on an empty stomach. A mixture of a glass of apple juice, homemade cranberry juice and a quarter glass of beetroot juice also raises hemoglobin well.

Erythrocytes are shaped elements of the blood that are not cells in the full sense of the word. They do not have nuclei (this device arose in order to accommodate more hemoglobin with the same volume of red blood cells). The main function of erythrocytes is transport of oxygen to every cell of the body and carbon dioxide in the opposite direction.

Since erythrocytes contain many different substances that are heavier than water, their density is greater than the density of blood plasma, and therefore, over time, erythrocytes settle if the blood does not move and mix. At various diseases the density of erythrocytes and blood plasma changes, and at the same time, the erythrocyte sedimentation rate (ESR) also changes. By these changes, it is possible to determine what exactly a person fell ill with.

For research, they usually take venous blood (although capillary blood is also possible). Special substances are added to the blood that help separate red blood cells from blood plasma and prevent blood clotting. Then the blood is left in the test tube for an hour and they look at how many millimeters the erythrocyte sedimentation occurred during this time.

Of course, it is impossible to see individual erythrocytes, but it is they who create the red color of the blood, and when they settle on top, a transparent layer of plasma is formed, where there are no more erythrocytes.

The norms of erythrocyte sedimentation rate can vary greatly in different categories of people. There is a clear relationship between ESR and age, ESR and gender. Consider the erythrocyte sedimentation rate in individuals of various categories.

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

As you can see, the ESR norm can vary greatly depending on the age and sex of the 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 by the ninth.

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

What about oncology?

In oncological diseases, a sharp increase in the erythrocyte sedimentation rate occurs. Typically, the settling rate increases by 70-80 millimeters per hour, that is, several times.

At the same time, a similar reaction can occur in the body to any inflammatory process, and therefore a simple increase in ESR is not a sign by which cancer can be diagnosed.

Therefore, if the ESR has increased, the person is sent for additional examination in order to find out what exactly caused the increase: cancer or simple inflammation.

Most often due to a change in ESR and subsequent follow-up examination detect such cancers:

• breast cancer;
• ovarian cancer;
• bone marrow cancer;
• Cervical cancer;
• Cancer of the lymph nodes.

There are cases of detection of other forms of cancer in this analysis with subsequent additional examination, but less frequently.

Benign tumor and ESR

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

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

What diagnoses, besides cancer, are characterized by an increase in ESR?

So, elevated ESR does not always mean cancer. Who else has this symptom? The erythrocyte sedimentation rate is increased with anemia(anemia) with normal erythrocyte morphology.

With anemia, the ratio of plasma and formed elements changes, and the erythrocytes settle with the formation of characteristic columns that an experienced specialist can distinguish.

There is an increase in ESR with kidney failure. At the same time, the level fibrinogen protein, which is provided by changes in the erythrocyte sedimentation rate. This mechanism of increasing ESR is also found in obesity to an extreme degree.

Blood in women in general and in pregnant women in particular, as well as in the elderly, erythrocytes in the blood also settle faster, as mentioned above. In addition, the rate of erythrocyte sedimentation may be higher due to laboratory error during the analysis.

In what cases can ESR be reduced?

The erythrocyte sedimentation rate decreases with a change in the morphology (external structure) of erythrocytes, an increase in the number of leukocytes (white blood cells), with an increase in the amount of bile salts in the blood plasma, during breastfeeding.

Since cancer lesions of various organs can lead to both an increase in the number of leukocytes and an increase in the amount of bile in the blood (this is cancer of the bone marrow and liver, respectively), it turns out that oncological disease gives two opposite effects that compensate for each other. Thus, the increase in the rate of erythrocyte sedimentation in cancer may be lower than expected.

ESR and chemicals

The use of various substances can affect the results of the analysis. For example, dextran, some hormonal contraceptives, vitamin A, and the hepatitis vaccine increase ESR.

Valproic acid, cortisone, glucose, fluorides, quinine can reduce this figure. That is why before the analysis you need to say that you took certain drugs. It is possible that the analysis will have to be postponed, since it is impossible to obtain a reliable result while these substances remain in the blood.

What tests are required besides ESR to determine cancer?

In addition to ESR, cancer affects the level of hemoglobin. With cancer of the stomach or intestines, the level of hemoglobin decreases, with cancer of other organs, too, but not so noticeably. In bone marrow cancer, a drop in hemoglobin levels can be observed with a decrease in the number of platelets and the rate of blood clotting.

Cancer cells also produce special substances that are not produced in healthy cells. These substances are called tumor markers, and it is their presence that is a serious indication of the presence of an oncological disease.

Moreover, it is almost impossible to determine brain cancer in this way, so it is not always possible to detect the disease with the help of tumor markers.

How to prepare for the analysis?

In order for the analysis to show the correct result, you need to follow a few simple recommendations: do not eat 8 hours before the analysis (that is, donate blood in the morning without breakfast), stop using it for 1-2 days alcohol, fried foods, and foods that are high in fat. Do not smoke for a couple of hours before the analysis.

If you use any medications at the time of the test, you need to tell the doctor about it, because medications can also affect the result.

Anyone who does not follow the rules for preparing for analysis runs the risk of getting an underestimated or overestimated result, which will result in suspicions of a serious illness and unnecessary worries.

Conclusion

Thus, the erythrocyte sedimentation rate is an indicator that does not remain in a person all his life, but changes over time, depending on age and state of the body. Of course, a speed increased by 60-70 units can be a sign of cancer, but not necessarily, because it could also change due to an inflammatory process, poisoning, or other reasons.

ESR also increases with the development of benign neoplasms. Therefore, there is no need to panic in case of an increase in ESR, instead, other tests should be taken and, based on their results, we should already talk about the diagnosis.