Abstract: Background and purpose: Glioma is the most common primary tumor of the central nervous system. This study aimed to investigate the clinical significance of cerebrospinal fluid (CSF) and plasma D-dimer levels and the relation with ventricular metastasis (VM) and spinal cord metastasis (SCM) of glioma. Methods: The CSF and plasma D-dimer levels were measured in 83 glioma patients. The glioma patients were divided into unrelapsed group and relapse group; parenchyma group, VM group and SCM group; primary spinal cord metastasis (PSCM) group and secondary spinal cord metastasis (SSCM) group according to the clinical characteristics. We investigated the relationship between the levels of CSF or plasma D-dimer and spinal cord metastasis or ventricular metastasis of glioma. Results: The CSF D-dimer level of relapse group was significantly higher than that of unrelapsed group (P=0.000 3). The CSF D-dimer level of SCM group was significantly higher than that of VM group (P=0.001 5). The CSF D-dimer levels of VM and SCM groups were significantly higher compared with parenchyma group (P=0.000 1, P=0.000 3). The CSF D-dimer level of SSCM group was significantly higher than that of PSCM group (P=0.000 5). The CSF D-dimer levels of VM (P=0.0001) and SCM groups (P=0.005 0) were significantly reduced after chemotherapy. The plasma D-dimer level of SCM group was significantly higher compared with VM group (P=0.023 5) and parenchyma group (P=0.000 5). There was no significant difference in the plasma D-dimer level between unrelapsed and relapse groups (P=0.371 8) or PSCM and SSCM groups (P=0.059 2). The plasma D-dimer levels of VM group (P=0.182 4) and SCM group (P=0.093 3) did not decrease significantly after chemotherapy. In the receiver operating characteristic (ROC) curve, the optimal cut-off points for CSF and plasma D-dimer levels were found to be 69 and 219 ng/mL in glioma patients with sensitivity and specificity of 86.75 %, 94.12% and 34.94%, 94.12%, respectively. Conclusion: D-dimer might be an important clinical marker for spinal cord metastasis or ventricular metastasis and response evaluation in glioma.

Key words: Glioma, Cerebrospinal fluid, D-dimer, Ventricular metastasis, Spinal cord metastasis