〔Abstract〕 To investigate the diagnostic value of combined detection of folate receptor-positive circulating tumor cells (FR+-CTCs) and hemostatic function indicators in improving the diagnosis of gastrointestinal tumors (GITs) metastasis. Methods A retrospective analysis was conducted on the clinical data of 186 patients aged 18 to 80 years who were diagnosed with gastrointestinal tumors via pathology and received treatment, including data on FR+-CTCs, hemostatic function indicators, and pathological staging. The collected data encompassed FR+-CTCs levels, coagulation parameters, and pathological staging. Statistical analysis included t-tests, chi-square tests, fisher’s exact test, logistic regression analysis, and receiver operating characteristic (ROC) curves to assess the diagnostic value of combined FR+-CTCs and coagulation parameters in detecting tumor metastasis. Results FR+-CTCs levels and positive rates demonstrated significant associations with clinicopathological characteristics (gender, histological type, N staging) in GITs patients (P<0.05). In patients with metastasis, elevated fibrinogen levels were observed, while both thrombin time and platelet counts showed significant increases in N1 ~ N3 stages (P<0.05). Logistic regression analysis showed that PLT and antithrombin III (AT-III) were independent risk factors for GITs metastasis (P<0.05). The areas under the ROC curves for predicting GITs metastasis were 0.678 (95%CI: 0.540-0.816) and 0.664 (95%CI: 0.512~0.815), respectively. When combining multiple factors, including FR⁺-CTCs, PLT, AT-III, pathological type, FIB, TT, and gender, for the diagnosis of GITs metastasis, the AUC increased to 0.757 (95%CI: 0.621-0.893), indicating higher sensitivity and specificity compared to using each indicator alone. Conclusion The combined detection of FR+-CTCs and anticoagulation function indicators has a higher diagnostic value for the diagnosis of GITs, providing a valuable basis for the early diagnosis of GITs, especially in metastasis surveillance.