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In medical practice, the need for a number of checks of the human body for the presence of pathological processes is constantly manifested. Modern devices can check the vital activity of the human body in all parameters - ultrasound, radiography, magnetic resonance imaging of the head and any other part of the body. Human health is reminiscent of a Swiss watch. But nature has presented an unpleasant surprise in the form of tumor neoplasms.

In this pathology, tissue cells stop multiplying under the control of internal regulations. They can form atypical tissues from damaged cells. Sometimes they change so much that it is impossible to determine their primary localization and origin.

The oncology begins asymptomatically. Pathology does not affect a person's well-being, and cancer cells develop in the body. The first important indicator indicating pathological processes in the body is the rate of erythrocyte sedimentation in the blood or the universal ability of cell adhesion and precipitation (ESR / ROE). Checking the ESR level in oncology is required. It shows the presence of changes in the ratio of protein components in blood plasma. Proteins are a waste product of tumor neoplasms, an elevated ESR level periodically indicates the presence of oncology.

The erythrocyte sedimentation rate depends on many physiological, pathological factors. The norm in adults depends on the age and gender of the person. A slight increase or decrease should remain within the limits set out below. Expressed in millimeters per hour:

In women under 20 years of age, the ESR results should not exceed 18 mm / h and fall below 2.
Women aged 20 to 55 years - 2-20. Women over 55 - the normal rate is no higher than 23.

For men, the acceptable rate is lower, since the body contains more blood cells than women. So the normal value of an adult male under 20 years old will be 12, 50 years old + over 55 - 19.

In children, regardless of gender, the norms of values \u200b\u200bare as follows:

from birth to six months - 2-5;

six months to a year - 4-8;

From one to 11 years old - 2-12;
From 11 to 18 years old - 2-15.

Rarely in a perfectly healthy person who is not affected by various factors leading to an increase in red cells in the blood, there is a change in the concentration rate of these elements of the main connective fluid. The reason for the deviations lies in the diet and the lack of specific micronutrients.

Deviations from the norm

An increase in the rate of sedimentation of red cells does not always indicate the formation of cancer cells in the body. The reasons are various:

high degree burns (third and fourth);
anemia (manifested as a consequence of deviations in the norm of erythrocytes);
anemia - a simultaneous decrease in iron and red cell enzymes;
a violation in blood clotting;
pathology in connective tissues, for example, arthritis, lupus;
intoxication of the body with various substances;
the autoimmune nature of the pathology (type 1 diabetes, multiple sclerosis, psoriasis);
chronic pathologies: HIV, chronic hepatitis, AIDS;
mechanical injuries;
rustitsky-Kalera disease (multiple myeloma) - a malignant tumor of plasma cells;
pregnancy;
during menstruation, the level of subsidence changes frequently.

Separately, it should be noted an increase in the erythrocyte sedimentation rate during pregnancy. This process is natural due to the peculiarities of changes in the hormonal background of a woman. It returns to normal within two to three weeks after delivery. The rate during pregnancy is up to 55 mm / h.

A decrease in the sedimentation rate of these elements is quite rare. Low subsidence causes:

lack of vitamins in the body;
anemia;
long-term use of aspirin, potassium chloride;
stomach problems - rare;
pathological liver problems;
deviations in the work of the lungs;
intestinal infections;
epilepsy;
necrosis of organ tissue;
amyloidosis is an accumulation of amyloid protein in tissues, which is absent in the body of a healthy person.

ESR level cannot determine oncological pathology. For this, other studies are carried out, studies showing a complete picture of human health.

Analyzes

To accurately determine the causes of deviations from the norm, and also to understand whether such a deviation is of an oncological nature, a whole complex of procedures and studies is carried out. Among the blood tests they take: general, biochemical, for tumor markers.

It is important to properly prepare for the delivery of the biomaterial, only then you can surely identify the exact abnormalities in the blood. Rules not to be ignored:

Donate blood on an empty stomach. Eating food - at least eight hours before delivery.
It is forbidden to use fried, salty, fatty and spicy, exclude coffee, strong tea (they contribute to vasospasm).
It is forbidden to consume alcoholic beverages and smoke before submitting the study material itself; after taking alcohol, at least a day must pass.
Cancel taking medications the day before delivery. If a person is undergoing treatment, drug cancellation is impossible - warn the laboratory.
Eliminate nervous strain, excessive physical exertion.

General blood analysis

It is the first stage of diagnostic blood tests. Identify violations associated with cancer. Checking the ESR level is an important element of a general blood test.

In addition to erythrocyte sedimentation, the analysis checks the iron rate, indicators of erythrocytes, leukocytes, platelets, red cell volume and blood clotting. All this is considered in a set of indicators.

The likelihood of a tumor will be indicated by the presence of lymphoblasts. A deterioration in coagulability will be revealed, an increase in leukocytes, platelets, and the volume of red cells occurs.

Blood chemistry

Reveals abnormalities of internal organs. Pathological processes are expressed in terms of:

increased sugar levels;
overestimated level of C-reactive protein;
increased creatinine.

The study of biochemical analysis involves the study of biomaterial to identify the erythrocyte sedimentation rate (ESR).

Research on tumor markers

A mandatory check for increased / decreased ESR is the determination of tumor markers. This is a specific substance of the tumor's vital activity. They determine the focus of pathology. There are a number of types of tumor markers:

CA 15-3 - breast cancer in women;
CA 125 - ovarian cancer;
AFP - tumor marker of tumors in the liver;
CEA - cancer of the intestine, bladder and uterus.

Tumor markers are detected by the reaction to reagents.

ESR analysis

ESR is carried out in two ways:

Panchenkov's method. Capillary method of material intake. The test material is diluted 1: 4 with a 5% chemical that contains sodium citrate. This solution is used to fill a test vessel in the form of a capillary tube. Then, within 60 minutes at a temperature of 20 degrees Celsius, the red bodies settle, a colorless liquid forms on top of the vessel. The length of this liquid determines the rate of erythrocyte sedimentation in the blood.
The Westergren method. International research standard that determines the level of erythrocyte sedimentation rate. Shows results with greater accuracy in contrast to Panchenkov's method. The pressure scale of the vessel for the study has two hundred divisions and material from a vein is used. The time for research is the same as in the previous method.

When an ESR test is prescribed

Determination of the ESR level is rarely prescribed, the analysis is carried out in conjunction with a general blood test. The study of the level of erythrocyte sedimentation rate is prescribed in the following cases:

With increased body temperature of a prolonged nature. Temperature is the first sign of inflammation.
With tumors. Reveals its character, helps to determine the localization, the degree of development.
For the accuracy of determining a particular disease associated with an increase in protein.

Relationship between ESR and oncology

The number of people with cancer is increasing every day. Millions die from cancer every year. The first stages of the disease do not appear, hence the trouble. The person simply does not know that he is sick. To do this, invariably, when the biomaterial is handed over, any medical institution checks the erythrocyte sedimentation rate, which shows the first symptoms of a possible disease.

The identification of the ESR indicator is carried out even in the state polyclinic. Therefore, analysis is the first call for further action when deviations are detected. Unfortunately, it happens that it is too late to heal. ESR will help to identify dangerous diseases in time, including oncopathology, and the attending physician will promptly prescribe a course of treatment.

As already mentioned, a change in the level of protein indicates the occurrence of inflammatory processes, which sometimes occur in oncological diseases, tumors.

With oncology, the level of ESR indicator increases to critical limits. There is an increase in the ESR level up to 70 mm / h, and maybe even higher. In this case, the level of hemoglobin, as a rule, decreases. When anti-inflammatory therapy does not change the indicators to the normal level and the treatment does not give results, this indicates the possible presence of cancer, the formation of cancer cells and tumors.

The rate of ESR in cancerous tissues depends on the stage and existence of metastases. But, as a rule, in cancer patients, the level of erythrocyte sedimentation is greatly overestimated, the indicators are close to a critical level or critical. However, in rare cases, even in the last stages of oncology, the ESR result remains normal.

In determining the rate of red blood cells, the level of hemoglobin plays an important role. The lower, the fewer red blood cells. The likelihood of a problem increases with a malignant brain tumor, when inflammatory processes occur in large vessels, with subsequent bleeding, or when the body is intoxicated with chemicals.

The readings of the erythrocyte sedimentation rate are amenable to correction upon timely detection. With the exclusion of pathologies, the norm is returned in two to four weeks with proper therapy. Such therapy is carried out on the basis of estrogens and glucocorticosteroids. Also shown is proper nutrition, the use of a vitamin complex and the exclusion of a factor that provoked an increase or decrease in the erythrocyte sedimentation rate.

Most often, ESR in a blood test is an indicator indicating the presence or absence of inflammatory processes in the body. Whether the ESR indicator is used as a diagnostic method for oncological diseases and whether it is informative for such a serious type of pathology, we will consider in this article.

ESR: what is it?

An indicator that carries information about how the blood is stratified into plasma and blood cells, namely the erythrocyte sedimentation rate, is called ESR. Previously, this analysis was referred to as ROE - erythrocyte sedimentation reaction. Most often, ESR is checked in conjunction with other indicators of a general blood test. But, for one reason or another, it can be recommended for delivery as a separate analysis.

As you know, cancer is the most dangerous pathology, which often leads to death. Loss of appetite, weakness, which most often accompany a cancer patient, people attribute to fatigue and do not go to the doctor. Cancer can be suspected by chance, when a person takes a complete blood count and the ESR indicator can be significantly higher than normal values. In this case, the specialist directs the patient for an additional examination in order to refute or confirm the presence of cancer in the body.

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Important! Only one ESR indicator cannot indicate the presence of cancer. To establish an accurate diagnosis, it is necessary to carry out a number of diagnostic procedures.

It should be noted that experts do not believe that only by a change in the ESR indicator, one can speak of the presence of malignant tumors. There are many cases when, even in the advanced stages of cancer, the erythrocyte sedimentation rate was normal. In addition, the rate of this analysis depends on several factors:

From the person's age and gender;
From the presence of chronic diseases;
In the presence of hormonal imbalance, a change in indicators is possible;
During pregnancy, as well as depending on the day of the menstrual cycle in women, the level of analysis may also change;

Usually, with such cancers as leukemia (blood cancer), malignant neoplasms in the lymph nodes, the presence of metastases, the value rises to critical levels.

Scientists have proven that erythrocyte sedimentation is affected by changes in the composition of the blood. When cancer cells multiply rapidly in the body, the amount of nonspecific protein in the blood increases, which is secreted by these malignant cells. And in inflammatory processes, the amount of acute phase proteins increases. Due to the fact that the concentration of all kinds of proteins in the blood increases, erythrocyte sedimentation is accelerated, which is revealed when donating blood.

Most often, an excess of the ESR level is observed in cancer of the breast, uterus, intestines, stomach. But, it should be noted that there are cases when, with the spread of cancer cells, the morphological structure of leukocytes changes, their number increases, the so-called leukocyte formula changes, which leads to a decrease in the indicator. Therefore, it is believed that ESR is not a reliable indicator of the presence of cancer in the body.

Although ESR is not a direct indicator of cancer, its significant changes become a strong argument for referring a patient to undergo a number of complex diagnostic measures.

Norm

ESR in a blood test is not a constant indicator. Its level depends on several factors. Even the time of day matters. So, during the day the value is higher than in the evening. During pregnancy, ESR is always above normal, especially in the second trimester. If, at the same time, the woman's health is satisfactory, then this fact does not bother the doctors. Approximately three weeks after delivery, these indicators should be normal.

Also, the norms depend on age and gender.

As you can see from the table, the values \u200b\u200bfor men and women are different. Experts explain this phenomenon by the fact that in women, due to physiological characteristics, the number of red blood cells is less, therefore, their sedimentation rate is faster.

Indicators for oncology

As mentioned earlier, it is impossible to judge the presence of oncological disease in the body only by changing the value. But, if the following changes in the clinical composition of the blood are observed in the tests, then the doctor may suspect the presence of cancer in the body:

If the value rises to 60-70 mm / h or more;
Usually, with indicators above the norm, they talk about the presence of inflammatory processes in the body. But, if a person is really sick with cancer, then when treating inflammation, the level of ESR does not decrease;
In blood tests, it can be found that against the background of an increase in ESR, hemoglobin decreases, along with an increase in ESR, the level of hemoglobin decreases to 70 g / l.

Usually, anemia, that is, a decrease in the number of red blood cells, often accompanies many cancers. This is especially true for tumors formed near the vessels, bone marrow. Cancer intoxication is also accompanied by severe anemia.

Attention! There is no definite ESR rate in the presence of a malignant tumor, since neoplasms manifest themselves in different ways and the human body is individual.

If the test results are unsatisfactory, the doctor recommends to retake them one day after the previous one. If the repeated analysis showed high ESR rates, then an extensive examination is prescribed in order to make an unambiguous diagnosis and determine the cause of the high rates.

Important! Only a doctor can decipher the analyzes. Self-diagnosis, especially in terms of the ESR level, is unacceptable, since this indicator can indicate many pathologies.

Determination of the ESR level in dynamics is also important during the treatment of cancer. So, during chemotherapy, as well as after surgery to remove neoplasms, ESR indicators should gradually return to normal. Otherwise, we can talk about a relapse or the presence of metastatic processes in the body. Once a month, doctors-oncologists, in the treatment of cancer, must check the level of ESR in the blood of patients.

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Analysis for ESR

Analysis to determine the ESR is not expensive. Roughly speaking, blood settling is performed for a certain time, after which the degree of erythrocyte precipitation is determined. There are several ways to determine:

Panchenkov's method is the most commonly used method for studying ESR. The blood is drawn from the finger. As you know, blood tends to clot. To avoid this during the analysis, use the anticoagulant sodium citrate. A 5% composition of this substance is used in a ratio of 1: 4 to blood. They are mixed in a special concave glass. Then the capillary tube is filled with this mixture. The analysis takes about an hour. Within an hour, the red blood cells settle, and a translucent liquid forms on top. It is the length of this liquid that is defined as the sedimentation rate of the red cells. This indicator is measured in millimeters per hour (mm / h). Also, when performing the analysis, the air temperature in the room has a role. It should vary within 20 0 С.
The Westergren method is an international standard in determining the ESR indicator. It differs in more accurate indicators compared to the Panchenkov method, since the scale of divisions in this method is two hundred. Another difference from the previous method is that blood is taken from a vein for analysis. The anticoagulant is mixed with blood in a test tube. The ESR level is also determined after an hour.

Experts, even in the absence of any health complaints, recommend taking ESR tests at least once a year. And after 45 years - every six months.

How to get tested

You should not eat in the morning before going to get tested. Drinking strong tea and coffee is also not recommended, since these drinks lead to vasospasm;
A few days before when to take the test, it is better to exclude fatty foods, alcohol from the diet, refrain from smoking, and also, if possible, not take medications that reduce blood clotting;
If there is a need to check the value in dynamics, then it is better to donate blood in the same laboratory in order to avoid errors in the analysis.

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 change beyond the disease state, in perfectly healthy people, especially in women. It is associated with the menstrual cycle, pregnancy and childbirth, and postpartum conditions.

Normal ESR indicators are:

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

How ESR is related to cancer

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

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

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

ESR level in oncological diseases

With such a serious pathology, its value rises to huge numbers, most often it is 70-80 mm / h. But it should be remembered: this indicator is not a specific tumor marker, and even more so it is 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 the clinical symptom and the results of other analyzes and diagnostic procedures. A simultaneous decrease in the hemoglobin content to 70 g / l may indicate a malignant process.

Serious deviations

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

The reasons may be:

Vaccination against hepatitis B;
The introduction of a large amount of heparin;
Anemic conditions;
Renal failure;
Obesity, hypercholesterolemia;
Taking oral contraceptives;
Elderly age;
Violation of the rules for the analysis.

All these reasons can lead to significant deviations in the ESR indicator.

Where to look for pathology?

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

Most often, it increases with the following types of formations:

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

If we talk about a benign process, then most often with its intestinal localization.

ESR analysis in cancer

It is a very important indicator, because it first gets 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, and this is its advantage. Diagnostics does not require any complex and expensive apparatus and reagents. Most often it is carried out according to the Panchenkov method. It includes the following steps:

Capillary blood sampling (from a finger) for research;
Placing it in a graduated glass tube and adding anti-clotting agents;
It is installed vertically and after an hour the results are measured (red blood cells settle, forming a vertical red column, its value is recorded in mm).

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

The erythrocyte sedimentation rate (ESR) is referred to as non-specific laboratory criteria. The ESR indicator is determined by the degree of agglutination of erythrocytes - this is the ability of cells to stick together and precipitate. ESR in oncology is one of the mandatory tests, since it is characterized by a high degree of sensitivity and reacts to any pathological processes in the body. However, the disadvantage of the technique is the low specificity of the criterion, so it is used as part of a comprehensive survey.

The prevalence of cancer is growing steadily every year. According to statistics, more than 5.5 million patients are diagnosed with cancer every year. A relationship was found between age and the frequency of occurrence: every second patient with oncopathology, as a rule, is over 60 years old.

At present, the etiology of oncopathologies, as well as the methods of treatment, remain an unresolved issue. At the same time, mortality from oncology occupies the 3rd position in the list of the main causes of death. This makes it possible to classify cancer as one of the most dangerous diseases, requiring the earliest possible diagnosis and adequate therapy.

The difficulty in early diagnosis of oncopathology lies in the possible long-term asymptomatic course of the disease. Often, the first clinical signs appear already at 2-3 stages, which complicates treatment and worsens the prognosis.

A blood test for tumor markers is not an obligatory preventive measure in the routine examination of patients, since the identification of this criterion is an expensive procedure. In turn, the determination of the ESR indicator is a mandatory analysis that is carried out to all people who take a general blood test in public and private clinics. Any deviation of the criterion under consideration from the norm is a signal of the development of a pathological process in the human body.

Important: in view of the low specificity, the erythrocyte sedimentation rate is not a sufficient criterion for making a final diagnosis.

A comprehensive examination of a patient includes laboratory and instrumental diagnostic methods. Based on the totality of the results of all studies, the attending physician makes a final diagnosis. This rule is especially important in the differential diagnosis of cancer.

ESR in oncology

The ESR indicator in oncology rises sharply to critical values. The highest rates are observed with multiple myeloma (chronic lymphocyte leukemia) and malignant granuloma (malignant neoplasm of the lymph nodes), as well as with the spread of metastases from the primary focus.

Patients often ask the question - why does ESR increase in the blood during oncology? It was found that increased aggregation of erythrocytes is facilitated by a change in the chemical composition of blood. So, 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, there is an acceleration of erythrocyte sedimentation rate as a result of an excessive amount of structural components of the blood.

How is the ESR indicator in the blood determined?

There are 3 methods for determining the criterion under consideration:

according to Panchenkov - the technique is implemented with the help of special capillaries for 100 divisions and Na citrate (anticoagulant), which prevents the coagulation of the blood under study. After mixing the capillary blood on a special concave glass with an anticoagulant, it is collected up to the control mark on the capillary. Then they are placed in an upright position in a tripod for 1 hour. The ESR value is recorded according to 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 the measured divisions on the capillary, the maximum value is 100 mm / h;
according to Westergren (in vitro) - an international standard. The test is carried out in test tubes for 200 divisions, the biomaterial is venous blood, which is mixed with an anticoagulant immediately after collection. Then 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 indicator is increased to 200 mm / h);
the micromethod is implemented on a special instrument-analyzer TEST1 with a maximum of 200 mm / h.

In any public hospital, it is possible 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 the reference (normal) values \u200b\u200bshould be selected taking into account the gender and age of the patient.

The gradation of the normal values \u200b\u200bis presented in the table.

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

Table of ESR indicators in oncology for men and women

Self-interpretation of the results for self-diagnosis is inadmissible. Only the attending physician should decipher all the data received. If, upon repeated analysis (after 1 day), consistently high values \u200b\u200bare recorded, then a large-scale screening examination of the patient is prescribed to make an accurate diagnosis.

The critical level of ESR (tenfold excess) in oncology and 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 lack of positive dynamics indicates a relapse of the disease or the start of metastatic processes. At the stage of therapy, monthly monitoring of the value under consideration is carried out in order to early identify the ineffectiveness of the chosen treatment tactics.

Does elevated ESR always indicate cancer?

The answer to this question from patients is definitely no. Possible reasons for exceeding the reference ESR values \u200b\u200bin addition to oncology:

an 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;
organ tissue necrosis as a result of insufficient blood supply;
mechanical injury;
intoxication of the body;
3-4 degree burns;
amyloid dystrophy, which is characterized by excessive accumulation of amyloid.

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

How to properly prepare for the study?

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, the last meal at least 8 hours before the procedure;
a strict exclusion of alcoholic beverages for 1 day is mandatory;
cancel any medications in 1 day in agreement with the doctor, if it is impossible - warn the laboratory about the medications taken;
it is allowed to drink clean unsweetened water without gas;
30 minutes before sampling biomaterial to exclude physical and emotional stress, and smoking is prohibited.

Summarizing

It must be emphasized:

the value of ESR in cancer of the ovaries, bone tissue, lymph nodes and other organs significantly deviates from the norm. The more severe the stage of the disease, the higher the indicators are recorded;
the test for determining 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;

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