Coagulation markers as independent predictors of colorectal cancer aggressiveness

Colorectal cancer (CRC) is frequently associated with thrombosis with thrombotic events, such as deep vein thrombosis or pulmonary embolism, often correlate with poor clinical outcomes. Coagulation markers have been suggested as potential prognostic indicators for CRC severity. However, the relationship with clinicopathological characteristics in CRC remains unclear. This study aims to examine the relationship between routine coagulation markers and clinicopathological characteristics in CRC patients. A retrospective analysis was conducted on 100 patients with confirmed diagnosis of CRC, classified according to the 2018 edition of the American Joint Committee on Cancer Tumor/Node/Metastasis staging system for malignant tumors. Clinicopathological characteristics and routine coagulation tests including prothrombin time, and international normalized ratio, activated partial thromboplastin time, prothrombin activity, thrombin time, fibrinogen, d-dimer, platelet count, were evaluated. Spearman correlation was used to assess correlations with clinicopathological characteristics. Additionally, univariate and multivariate ordinal regression analysis were conducted to detect the independent predictors for CRC aggressiveness. Our data documents several associations between coagulation markers and cancer progression markers. Specifically, positive correlations were identified between fibrinogen and d-dimer levels and each of the following: carcinoembryonic antigen, carbohydrate antigen, tumor stage, node involvement, and metastasis. Regression analysis showed, d-dimer (OR = 1.102, p < 0.001) and fibrinogen (OR = 1.002, p < 0.001) are independent predictors of high-risk CRC cases. Fibrinogen and d-dimer may serve as independent predictive biomarkers for CRC aggression. Their clinical utility could support personalized treatment plans for CRC patients.