Tumor metastasis is closely related to the coagulation system.
Tumor metastasis and
hypercoagulability promote each other through multiple mechanisms. However, whether coagulation indicators can reflect
tumor metastasis remains to be explored. Clinical characteristics of a total of 3447 patients from three tertiary referral centers were collected. Then the diagnostic efficacy of
FDP,
D-dimer and GC
tumor markers [
Carcinoembryonic antigen (CEA),
Carbohydrate antigen 19-9 (CA19-9) and
Carbohydrate antigen 72-4 (CA72-4)] for GC
metastases was evaluated by the receiver operating characteristic curve (ROC) analyses. Then we conducted a joint ROC curve analysis. The effects of coagulation parameters and
tumor markers on
gastric cancer metastasis were assessed using multiple logistic regression analysis. 2049 patients were diagnosed with primary GC, 1398 patients with metastatic GC. Based on comparison of AUC,
FDP (cutoff, 1.915) had significantly higher diagnostic efficacy than
fibrinogen (P<0.001), CEA (P<0.001), CA199 (P<0.001) and CA724 (P<0.001). No significant difference was observed between
D-dimer (cutoff, 0.905) and
FDP (P=0.158). The AUC of
tumor markers combined with coagulation indexes was higher than that without combination (P<0.001). In multiple logistic regression analysis, age, smoking,
D-dimer,
FDP, CEA, CA19-9, CA72-4 were found to be significantly associated with GC
metastasis (all P<0.001, except for smoking P=0.004). We conclude that plasma
FDP and
D-dimer may be novel clinical
biomarkers for screening
metastases of GC.