Differentiating benign and malignant neoplasms: A new role for coagulation and fibrinolysis indicators

Abstract

Abstract Background Abnormal coagulation and fibrinolysis are often observed in malignant tumors, which may contribute to tumor invasion. This study aimed to investigate the potential of using coagulation and fibrinolysis markers for differential diagnosis. Methods The levels of PT, APTT, TT, FIB, FDP, and D-dimer were analyzed in primary tumors (208 benign and 243 malignant) prior to biopsy or treatment. Additionally, a control group consisting of 400 healthy volunteers was included. Results Significantly higher levels of PT, FIB, FDP and D-dimer were found in the malignant tumor group compared with both the benign tumor group and control group (P > 0.01). The AUCs for FIB and D-dimer in diagnosing malignant tumors were 0.829(95% CI:0.780 ~ 0.878)and 0.845(95% CI:0.799 ~ 0.892), respectively. - both exceeding 0.8; their specificities for detecting malignancy were also high at 91.18% and 92.16%, respectively; while their positive predictive values reached up to 91.82% and 92.73%, respectively. Furthermore, the combined detection of PT,FIB,D-dimer,and FDP as well as that of only FIB and D-dimer combined could achieve an even higher diagnostic accuracy with AUCs were 89.22% and 89.26%, respectively;specificities for detecting malignancy were 89.22% and 89.26%,while their positive predictive values were 91.79% and 91.03%. Finally, a combination factor involving these markers could provide valuable assistance in distinguishing between benign and malignant tumors. Conclusion The use of FIB and D-dimer alone and the combined use of coagulation system function-related indicators (such as the combination of D-dimer and FIB or the combination of PT, FIB, FDP and D-dimer) have high auxiliary diagnostic value in the differential diagnosis of benign and malignant tumours.