Introduction Dysregulation of the coagulation and fibrinolytic systems has been closely linked to cancer progression and metastasis. This study investigated whether the coagulation- and fibrinolysis-related biomarkers, TAT, PIC, TM, and tPAIC, are correlated with cancer metastasis. Methods Plasma levels of TAT, PIC, TM, and tPAIC were measured in 240 treatment-naive patients with lung, ovarian, breast, or colorectal cancer and 120 healthy individuals. Participants were categorized into metastasis, non-metastasis and healthy groups based on clinical evaluation and imaging results. Statistical analysis and ROC curves were used to assess the performance of individual and combined biomarkers in detecting metastasis. Results All four biomarkers were significantly elevated in patients with metastasis ( P < .001). In multivariate logistic regression analysis, PIC demonstrated the strongest association with metastasis. ROC curve analysis revealed that in lung cancer patients, a parallel test of TAT and PIC achieved a sensitivity of 93.33% and an NPV of 88.24%. In ovarian cancer, a serial test of TAT, PIC, and TM achieved a specificity of 80.00% and a PPV of 75.00%. In breast cancer, a parallel test of TAT, PIC, and tPAIC yielded a sensitivity of 93.33% and an NPV of 89.47%. In colorectal cancer, a parallel test of all four markers achieved a sensitivity of 96.67% and an NPV of 93.75%. Conclusion Distinct combinations of coagulation and fibrinolysis biomarkers demonstrate high diagnostic performance for detecting metastasis across different cancer types. Tailoring biomarker panels according to cancer type may provide significant clinical value in monitoring and predicting cancer metastasis.
Zhao et al. (2026) studied this question.