Hikmet ÖZTOP, Nevriye Gül ADA TAK, Ceren Sevinç KAHRAMAN, Celaleddin DEMİRCAN, Fazıl Çağrı HUNUTLU
Uludağ Üniversitesi Tıp Fakültesi Dergisi - 2025;51(3):489-495
A significantly elevated erythrocyte sedimentation rate (ESR >=100 mm/h) is often linked to serious conditions, including infections, autoimmune disorders, and malignancies. However, because ESR is a nonspecific marker, it can be challenging to prioritize patients for cancer investigations. While conditions like multiple myeloma can be identified through specific tests, there are no equally definitive markers for other malignancies. This study examined whether routine laboratory parameters could enhance diagnostic value. We retrospectively analyzed 124 adult patients with an ESR >=100 mm/h admitted to Bursa Uludağ University Internal Medicine Clinic from January 2020 to April 2024. After excluding those with incomplete laboratory data, undiagnosed cases, and plasma cell dyscrasias, 46 patients remained in the final cohort. In our analysis, we found that hemoglobin, albumin, and lactate dehydrogenase (LDH) were significant predictors of malignancy in univariate analyses. We developed the HALD score, calculated as (Hemoglobin (g/dL) x Albumin (g/L) / LDH (U/L), which demonstrated good diagnostic performance, with an area under the ROC curve of 0.749 (95% CI: 0.567 -0.932). An optimal cut-off value of 1.45 resulted in a sensitivity of 66.7% and a specificity of 84%. These results suggest that combining inexpensive and readily available laboratory parameters into a scoring system can help identify patients with high ESR who should be prioritized for further evaluation of malignancy.
