Erythrocyte Sedimentation Rate Measurements by TEST 1 Better Reflect Inflammation Than Do Those by the Westergren Method in Patients With Malignancy, Autoimmune Disease, or Infection

Choong-Hwan Cha, MD; Chan-Jeoung Park, MD, Young Joo Cha, MD; Hyun Kyung Kim, MD; Duck Hee Kim; Honghoon; Jae Hoon Bae; Jae-Seol Jung; Seongsoo Jang, MD; Hyun-Sook Chi, MD; Dong Soon Lee, MD; Han-Ik Cho, MD

Disclosures

Am J Clin Pathol. 2009;131(2):189-194. 

In This Article

Results

Comparison Between TEST 1 and Westergren Methods

ESR was measured in 154 blood samples by the TEST 1 and Westergren methods. The mean ± SD ESR was 46.1 ± 22.3 mm/h (range, 20–108 mm/h) for TEST 1 and was 57.1 ± 25.3 mm/h (range, 10–118 mm/h) for the Westergren (P < .0005). There was a significant correlation between TEST 1 and Westergren measurements (r 2 = 0.386; P < .0005). Bland-Altman analysis showed a negative mean bias, equal to –10.95 mm/h (limits of agreement, –29.9 to 51.8), indicating that the TEST 1 values were lower than were the Westergren values (95% confence interval, –14.27 to –7.63) Figure 1.

Figure 1.

Comparison of  TEST 1 and Westergren Methods for Erythrocyte Sedimentation Rate (ESR) Measurements. A, Scattergram of Correlations Between the Methods (r2 = 0.386; P < .0005; y = 0.547x + 14.881). B, Plot of the Differences Between ESR Measurements (y-axis) vs Average ESR Values (x-axis) (n = 154). Dotted Lines Denote the Limits of Agreement.

Correlations Between Inflammatory Plasma Protein Levels and ESR Values

Overall, in all 154 patient samples, there were significant correlations between total protein, globulin, CRP, α1-, α2-, and β2-globulin levels and Westergren method data and between total protein, globulin, CRP, α1-, α2-, β2-, and γ-globulin and TEST 1 results Table 2 . TEST 1 values showed a significant correlation with γ-globulin concentrations, whereas the Westergren data d not. In addition, the correlation coefficients were higher for TEST 1 data than for Westergren results. This finding was also observed when we compared correlations according to patient diagnoses Table 3 , Table 4 , Table 5 , and Figure 2. Only the TEST 1 method showed significant correlations with total protein, globulin, α2-, and β1-globulin concentrations in samples from patients with autoimmune diseases and with α1-globulin in patients with infections.

Figure 2.

Correlations of TEST 1 Erythrocyte Sedimentation Rate (ESR) Values (A) and Westergren ESR Values (B) with β2-globulin Concentrations in Samples of Patients with Infection (n = 41) (A, r2 = 0.566; P = 1.41 × 10–8; B, r2 = 0.130; P = .020). Values for β2-globulin are Given in Conventional Units; to Convert to Système International Units (g/L), Multiply by 10.0.

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