Bade Benjamin, Zdebik Alexander, Wagenpfeil Stefan, Gräber Stefan, Geisel Jürgen, Vogt Thomas, Reichrath Jörg
Center for Clinical and Experimental Photo-Dermatology, Department of Dermatology, The Saarland University Hospital, Homburg, Germany.
Institute of Medical Biometry, Epidemiology and Medical Informatics, The Saarland University Hospital, Homburg, Germany.
PLoS One. 2014 Dec 1;9(12):e112863. doi: 10.1371/journal.pone.0112863. eCollection 2014.
Low vitamin D status (serum 25(OH)D concentration) is associated with increased incidence and unfavourable outcome of various types of cancer. However, there are limited data on influence of serum 25(OH)D on risk and prognosis of malignant melanoma.
Basal serum 25(OH)D concentrations were retrospectively analyzed in a cohort of melanoma patients (n = 324) and healthy controls (n = 141). We tested the hypothesis that serum 25(OH)D concentrations are predictive of melanoma risk, thickness of primary melanomas, and overall survival (OS).
Median serum 25(OH)D concentrations were significantly lower (p = 0.004) in melanoma patients (median = 13.6 ng/ml) as compared to controls (median = 15.6 ng/ml). Primary tumors of patients with low serum 25(OH)D concentrations (<10 ng/ml) had significantly (p = 0.006) greater Breslow thickness (median: 1.9 mm) as compared to patients with higher levels (>20 ng/ml; median: 1.00 mm). Patients with 25(OH)D serum concentrations in the lowest quartile had inferior overall survival (median: 80 months) comparing with the highest quartile (median: 195 months; p = 0.049).
Our data support the concept that serum 25(OH)D concentrations are associated with risk and prognosis of melanoma. Whether normalizing serum 25(OH)D concentrations in these patients improves outcomes will require testing in future clinical trials.
低维生素D状态(血清25(OH)D浓度)与各类癌症的发病率增加及不良预后相关。然而,关于血清25(OH)D对恶性黑色素瘤风险及预后影响的数据有限。
对一组黑色素瘤患者(n = 324)和健康对照者(n = 141)的基础血清25(OH)D浓度进行回顾性分析。我们检验了血清25(OH)D浓度可预测黑色素瘤风险、原发性黑色素瘤厚度及总生存期(OS)这一假设。
黑色素瘤患者的血清25(OH)D浓度中位数(中位数 = 13.6 ng/ml)显著低于对照组(中位数 = 15.6 ng/ml,p = 0.004)。血清25(OH)D浓度低(<10 ng/ml)的患者的原发性肿瘤,与浓度较高(>20 ng/ml;中位数:1.00 mm)的患者相比,其Breslow厚度显著更大(中位数:1.9 mm,p = 0.006)。血清25(OH)D浓度处于最低四分位数的患者的总生存期较差(中位数:80个月),而最高四分位数的患者为(中位数:195个月;p = 0.049)。
我们的数据支持血清25(OH)D浓度与黑色素瘤风险及预后相关这一概念。在这些患者中使血清25(OH)D浓度正常化是否能改善预后,将需要在未来的临床试验中进行验证。