结肠癌组织P300/CBP相关因子表达及其临床意义

目的检测结肠癌组织中P300/CBP相关因子(P300/CBP-associated factor,PCAF)的表达及其临床意义,并探讨其对结肠癌细胞生长和凋亡的影响。方法收集2008-01-01-2012-12-31,在青海省第五人民医院肿瘤科手术切除的58例结肠癌及对应癌旁组织,应用免疫组化染色技术检测PCAF蛋白表达,分析PCAF蛋白表达与临床病理参数的相关性;应用逆转录病毒介导的PCAF过表达质粒上调人结肠癌HT29细胞中PCAF表达,BrdU细胞增殖分析、MTT法和流式细胞术检测肿瘤细胞生长和凋亡变化。结果 PCAF蛋白在结肠癌和癌旁组织中的阳性表达率分别为37.9%(22/58)和86.2%(50/58),χ2=28.707,P<0.05;PCAF蛋白阳性表达与结肠癌肿瘤分化和临床分期相关,P<0.05。结肠癌HT29细胞分别感染逆转录病毒介导的对照组和实验组,蛋白表达水平差异有统计学意义,P<0.05;对照组与实验组细胞增殖水平分别为122.30±2.79和56.13±3.46,P<0.05;对照组与实验组细胞活力分别为1.83±0.02和0.85±0.02,P<0.05;实验组PCAF导致细胞凋亡率为(31.10±1.93)%,明显高于对照组的(5.57±0.77)%,P<0.05。结论 PCAF在结肠癌组织中表达下调或缺失,其阴性表达与恶性临床病理参数有关,过表达PCAF导致肿瘤细胞生长减弱和凋亡增加,提示PCAF可能成为结肠癌靶向治疗的潜在靶点。     

上皮性卵巢癌组织CK2β和p53蛋白表达临床意义分析

目的研究蛋白激酶CK2β及抑癌基因蛋白p53在卵巢癌组织中的表达情况,并分析其表达与卵巢癌临床病理参数及预后的关系。方法收集2003-01-01-2005-12-31就诊于浙江大学医学院附属妇产科医院的上皮性卵巢肿瘤患者148例(包括108例上皮性卵巢癌,20例卵巢良性上皮性肿瘤及20例卵巢交界性肿瘤),应用免疫组化法检测CK2β及p53在肿瘤组织中的表达情况,并分析两者在不同肿瘤组织中的表达差异及其与上皮性卵巢癌预后的关系。结果上皮性卵巢癌组织CK2β阳性表达68例(63.0%),p53阳性表达58例(53.7%);卵巢交界性肿瘤CK2β阳性表达6例(30.0%),p53阳性表达4例(20.0%);卵巢良性上皮性肿瘤CK2β和p53阳性表达均为0例;CK2β在卵巢癌组织中的表达强度显著高于卵巢良性肿瘤组织(P<0.001)和交界性肿瘤组织(P=0.003);p53在卵巢癌组织中的表达强度显著高于卵巢良性肿瘤组织(P<0.001)及交界性肿瘤组织(P=0.006);CK2β和p53之间具有显著相关性,r=0.377,P<0.001。CK2β蛋白表达与卵巢癌临床分期(P=0.001)、术前血清CA125水平(P<0.001)及化疗敏感性(P=0.012)显著相关;p53蛋白表达与组织分化程度(P=0.027)及术前血清CA125水平(P=0.027)相关。CK2β及p53阳性表达与上皮性卵巢癌患者的无瘤生存预后及总生存预后显著相关(P值均<0.05);多因素回归显示,临床分期(P<0.001)和p53阳性表达(P=0.018)可作为预测卵巢癌无瘤生存预后的独立因素,而临床分期(P=0.001)、术前CA125水平(P=0.040)和p53阳性表达(P=0.041)可作为预测卵巢癌总生存预后的独立因素。结论 CK2β和p53蛋白阳性表达可能与卵巢癌的发生发展有密切关系,p53阳性表达对卵巢癌预后预测具有一定的价值。     

结肠癌组织NPRL2表达及其临床意义研究

目的观察结肠癌组织中抑癌基因NPRL2的表达情况,并探讨其临床意义。方法收集2012-07-05-2012-12-21郑州大学第二附属医院普外科经手术治疗40例患者的结肠癌组织及其正常组织。应用半定量反转录-聚合酶链反应(RT-PCR)检测NPRL2mRNA的表达水平,蛋白质印迹法和免疫组织化学技术检测NPRL2的蛋白表达情况。结果RT-PCR结果显示,NPRL2mRNA在结肠癌组织的表达水平为0.459±0.045,显著低于正常组织的0.656±0.041,t=15.124,P<0.001。蛋白质印迹结果显示,结肠癌组织和正常组织的蛋白表达量分别为0.271±0.015和0.588±0.051,t=27.357,P<0.001。免疫组化结果显示,正常组织及肿瘤组织中NPRL2蛋白阳性率分别为87.50%(35/40)和32.50%(13/40),组间差异有统计学意义,χ2=17.802,P<0.001。NPRL2的表达与患者的性别(χ2=0.631)、年龄(χ2=0.684)和Dukes分期(χ2=0.743)无明显相关关系,P值均>0.05;而与肿瘤组织分化级别相关,高、中分化组NPRL2阳性表达率高于低分化组,χ2=4.862,P<0.05。结论 NPRL2在结肠癌组织中表达降低,而且其表达与结肠癌的分化程度有关,提示其可能对结肠癌的发生或发展有重要的作用。     

上皮性卵巢癌组织E-cadherin mRNA表达临床意义的研究

目的:研究E-钙黏附蛋白(E-cadherin,E-cad)mRNA在正常卵巢、上皮性卵巢良性肿瘤及上皮性卵巢癌组织中的表达,并探讨E-cad表达与上皮性卵巢癌临床病理特征的关系。方法:用荧光定量-PCR法(FQ-PCR)分别检测正常卵巢上皮组织、卵巢上皮性良性肿瘤以及上皮性卵巢癌组织中E-cad的表达水平。结果:E-cad在10例正常卵巢上皮组织中表达为0,阳性表达率0;在10例良性卵巢上皮性肿瘤组织中阳性表达为0.261 7±0.138 2,阳性表达率为100%;在30例恶性卵巢上皮性肿瘤组织中阳性表达为0.012 7±0.018 1,阳性表达率为50%;3组间比较差异有统计学意义,χ2=30.924,P<0.05。E-cad的表达与FIGO分期成负相关,r=-0.873,P<0.05;与患者的生存时间呈正相关,r=0.602,P<0.05。E-cad表达与其组织学类型无相关性,χ2=3.811,P>0.05;与病理分级无相关性,χ2=3.458,P>0.05。结论:E-cad可作为上皮性卵巢癌病情进展和预后判断的指标之一,为分子靶向治疗提供一个依据。     

氨肽酶P2在上皮性卵巢癌组织中的表达及临床意义

目的 探讨氨肽酶P2(XPNPEP2)表达与上皮性卵巢癌临床病理特征和预后的关系。方法 收集2019年1月至2021年9月郑州大学第一附属医院收治的15例非癌患者正常卵巢组织、40例上皮性卵巢癌患者原发灶和与之配对的35例转移癌灶和癌旁组织。采用免疫组化法及蛋白印迹法检测组织中XPNPEP2的表达;分析其与上皮性卵巢癌患者临床病理特征的关系。使用基因表达谱动态分析(GEPIA)数据库分析XPNPEP2表达与卵巢癌患者生存预后的关系。结果 上皮性卵巢癌原发灶中XPNPEP2高表达率为82.50%(33/40),正常卵巢组织为13.33%(2/15)(χ²=22.553,P<0.001)。转移癌灶中XPNPEP2高表达率为91.43%(32/35),癌旁组织高表达率为14.29%(5/35)(χ²=41.794,P<0.001)。上皮性卵巢癌患者XPNPEP2表达水平与患者年龄、病理类型、分化程度、肿瘤大小、腹水以及FIGO分期均无相关性(χ²=0.519,P=0.471;P=0.204;χ²     

YAP蛋白在胃腺癌中的表达情况及其临床意义

目的 探讨胃腺癌中YAP蛋白的表达情况及其与胃腺癌患者临床病理特征及预后之间的关系.方法 应用免疫组织化学法检测人胃腺癌组织中YAP蛋白的表达情况,并用Kaplan-Meier单因素生存分析法和Cox模型多因素回归分析法分析YAP蛋白表达与胃腺癌患者的临床病理特征及预后之间的关系.结果 胃腺癌组织中YAP蛋白的细胞质阳性表达(31.6%vs 1.0%)、细胞核阳性表达(22.4%vs 0.0%)均明显高于正常胃黏膜组织(P<0.01).YAP蛋白细胞质阳性表达与细胞核阳性表达呈正相关(Spearman相关系数=0.5818,P<0.0001).Kaplan-Meier单因素生存分析结果显示,YAP蛋白细胞核阳性组患者的5年生存率较YAP蛋白细胞核阴性组低(P<0.05).Cox模型多因素回归分析显示,YAP蛋白的表达未能作为胃腺癌患者预后的独立预测因子(P>0.05).结论 部分胃腺癌组织中存在YAP蛋白的高表达,且YAP蛋白细胞核表达的胃腺癌患者的预后较差,可以作为此病的早期诊断指标.     

Hexokinase 2在卵巢癌中的表达及临床病理意义

目的：探讨卵巢癌中Hexokinase 2（HK-2）表达的临床病理意义。方法：免疫组化检测56例卵巢癌组织及10例癌旁组织中HK-2的表达情况,并对临床病理数据进行分析。MTT法和流式细胞分析分别检测siRNA沉默HK-2蛋白对卵巢癌Skov3细胞增殖及凋亡的影响。Western Blot检测凋亡蛋白Caspase-3的表达。结果：10例癌旁组织中均未见HK-2阳性表达,56卵巢癌中HK-2的阳性表达率为53.6%（30/56）。HK-2高表达与卵巢癌患者肿瘤分期较高（P＝0.018）、肿瘤淋巴结转移密切相关（P＝0.035）,但与患者年龄（P＝0.410）、肿瘤组织学分级（P＝0.108）、肿瘤组织学类型（P＝0.122）、复发（P＝0.160）无显著相关性。siRNA沉默HK-2蛋白抑制卵巢癌Skov3细胞增殖,促进凋亡。Western Blot检测蛋白提示siRNA沉默HK-2蛋白促进了调亡蛋白Caspase-3的表达。结论：卵巢癌中存在HK-2高表达,HK-2在卵巢上皮癌可能发挥了促进肿瘤发生和进展的重要作用,可能是一种新的上皮卵巢癌治疗靶点。     

Yes相关蛋白在小细胞肺癌中的表达及意义

目的:探讨YAP(Yes-associated protein,YAP)蛋白在小细胞肺癌组织中的表达及其临床意义.方法:应用免疫组织化学检测106例小细胞肺癌组织标本和25例癌旁组织标本,分析其与患者临床病理特征及预后的关系.结果:小细胞肺癌组织中YAP阳性表达率为68.9%(73/106),癌旁组织中YAP阳性表达率为12%(3/25),差异具有统计学意义(P<0.05).在小细胞肺癌组织中,YAP表达与临床分期(P=0.021)、淋巴结转移(P=0.032)、转移病灶数目(P=0.007)、血清NSE水平(P=0.034)和血清LDH水平(P=0.037)有关.单因素生存分析显示,临床分期(P<0.001)、淋巴结转移情况(P=0.018)、病灶转移数目(P=0.004)、心包浸润(P=0.009)、血清NSE水平(P=0.01)、血清LDH水平(P=0.008)和YAP表达(P=0.001)与预后相关.进一步多因素分析显示,临床分期(P=0.001)、淋巴结转移(P=0.012)、心包浸润(P=0.009)和YAP表达(P=0.003)为总生存期的独立预测因子.结论:YAP在小细胞肺癌中具有较高的表达率,其表达情况与肿瘤的进展密切相关.YAP 蛋白表达可作为判断小细胞肺癌患者预后的一个预测指标.     

沉默血管生成素-2表达对人肺腺癌细胞生物学特性的影响

背景与目的促血管生成素-2(Ang-2)是一类调节血管生成的重要细胞因子,与肿瘤的发生发展有密切的联系.本研究通过腺相关病毒(adeno-associated virus,AAV)介导的RNA干扰(RNAinterference,RNAi)抑制肺腺癌细胞A549Ang-2的表达,观察其对癌细胞生物学特性的影响.方法构建H1启动子驱动的表达针对Ang-2的小干扰RNA(siRNA)重组腺相关病毒(AAV-Ang-2shRNA),转染A549细胞,同时以正常A549细胞及其转染空病毒(AAV-Null)的A549细胞作为对照,观察RNAi沉默Ang-2表达在体外及体内对A549细胞生长、致瘤、增殖、凋亡及肿瘤微血管密度的影响.结果体外实验结果表明重组腺相关病毒转染A549细胞48 h后Ang-2蛋白表达比对照组明显降低(P＜0.001);细胞生长明显减慢(P＜0.001).RNA干扰后A549细胞细胞周期分析结果提示A549细胞对照组、AAV-Null对照组和AAV-Ang-2thRNA验组的增殖指数(proliferation index,PI)分别为0.51±0.43、0.48±0.29和0.26±0.31.AAV-Ang-2shRNA验组与对照组比较,PI明显减少(P=0.001).体内实验结果表明,AAV-Ang-2shRNA实验组在胸腺缺陷小鼠成瘤体积、瘤质量均明显低于两对照组(P＜0.01).各组微血管密度分析结果分别为46.4+13.1、44.2+13.6和34.9±12.8;AAV-Ang-2shRNA实验组肿瘤组织内新生血管数目明显低于对照组(P＜0.001).各组凋亡指数(apoptosisindex,AI)分别为(5.98±3.11)％、(7.51±4.42)％及(17.06±7.43)％.AAV-Ang-2shRNA组比PBS组、AAV-Null组凋亡百分率明显增高(P=0.005,P=0.007).各组细胞增殖核抗原(proliferating cell nuclear antigen,PCNA)阳性表达率分别为(92.75+9.7)％、(85.8±11.8)％、(69.8+16.5)％;AAV-Ang-2shRNA组PCNA指数低于两对照组(P=0.014,P=0.021).结论腺相关病毒介导的siRNA表达能明显抑制A549细胞中Ang-2的表达,减慢肿瘤细胞的增殖,促进肿瘤细胞凋亡,抑制肿瘤生长.     

胃癌组织MACC1表达及其临床意义分析

目的:研究结肠癌转移相关基因1(MACC1)在胃癌组织中的表达及其临床意义。方法:采用RT-qPCR检测胃癌组织株和67例胃癌组织及癌旁正常组织中MACC1mRNA的表达,免疫组化技术检测67例胃癌组织及癌旁正常组织中MACC1蛋白的表达,并分析其与临床病理资料的关系。结果:BGC823、SGC7901和MGC803 3种胃癌细胞株中MACC1mRNA的相对表达量分别为3.458 4±0.047 9、4.768 5±0.100 6和4.257 5±0.029 5,差异有统计学意义,F=295.131,P<0.05。癌组织MACC1mRNA表达量(5.560 0±2.853 1)较癌旁正常组织(2.190 1±1.675 9)显著增高,t=6.907,P=0.000。肿瘤组织中MACC1蛋白的阳性率为64.18%(43/67),显著高于癌旁正常组织5.97%(4/67),χ2=49.844,P<0.05,且MACC1蛋白的异常高表达与分化程度(χ2=14.492,P=0.000)、腹膜转移(χ2=4.251,P=0.039)、淋巴转移(χ2=11.978,P=0.001)、临床分期(χ2=11.024,P=0.001)密切相关,而与年龄(χ2=0.129,P=0.720)、性别(χ2=0.407,P=0.523)、肿瘤大小(χ2=0.017,P=0.897)、部位(χ2=3.021,P=0.082)及远处转移(χ2=0.000,P=1.000)无关。结论:MACC1可以作为预测腹膜转移、淋巴转移,评价胃癌进展的有效指标,可为胃癌患者的临床诊疗提供依据。     

Religiosity and Physical and Emotional Functioning Among African American and White Colorectal and Lung Cancer Patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。     

Occupational and environmental radiation and cancer

Epidemiologic evidence on the relation between occupational and environmental radiation and cancer is reviewed. Studies of pioneering radiation workers, underground miners, and radium dial painters revealed excess cancer deaths and contributed to the setting of radiation protection standards and to theories of carcinogenesis. Occupational exposures today are generally much lower than in the past, thus any associated increases in cancer will be difficult to detect. Pooling investigations of these more recently exposed workers, however, has the potential to validate current estimates of risk used in radiation protection. New information on the effects of chronic radiation exposure also may come from studies in the former Soviet Union of Chernobyl clean-up workers and of workers at the Mayak nuclear facilities. Studies of environmental radiation exposures, other than radon, are largely inconclusive, due mainly to the difficulties in detecting the low risks associated with low dose exposures. Thyroid cancer, however, has been linked to environmental radiation from the Chernobyl accident and from nuclear weapons tests. Low-level radiation released during normal operations at nuclear plants has not been found to increase cancer rates in surrounding populations. Radon, a human carcinogen, is the most ubiquitous exposure to human populations; remediating high residential-radon levels is recommended, recognizing that the exposure can never be removed completely because it occurs naturally.     

Cell and tissue interactions in carcinogenesis and metastasis and their clinical significance

This review describes a new vision for future directions in the study of metastatic cancer biology and pathology. It is based upon clinical and experimental observations on the constituent cell lineages within a neoplasm and on tumour-host interactions. The vision incorporates information from studies in population biology, developmental biology and experimental pathology as well as investigations upon human malignant disease. The assembled information reveals that invasion and metastasis are supra-cellular manifestations of "emergent behavior" among combinations of normal and malignant cell lineages in vivo. Emergent behavior is a combinatorial interactive process in which a population displays new traits which cannot be achieved by individuals acting separately and which subside when the specific population mix disaggregates. Disruption of such pathological interactions in the field of a developing primary or secondary tumour is, therefore, required to disable the malignant population and arrest progression without tissue destruction. These conclusions originate, in part, from principles which govern the sociobiology and group behavior of bees, ants, fish, birds and human societies. In all these social organisms, external factors can disrupt signaling mechanisms and induce expanding self-perpetuating rogue behavior, leading to social disintegration. These principles also apply to cellular societies composing higher animals, which likewise need intrinsic rules to maintain social order and avoid anarchy, and recognition of this is essential for advancing future research on the mechanisms involved in carcinogenesis and metastasis. Summarised evidence is presented here to support the conclusion that miscommunications between cells and tissues in the region of the developing tumour and its metastases are the main direct perpetrators of malignant disease. Genetic lesions (mutations, deletions, translocations, reduplications, etc.), commonly seen in cancers, can significantly disrupt important molecular pathways in the networks of communications needed to sustain orderly tissue/organ structure and function. However, genetic lesions can also, themselves, be induced by abnormal cell interactions initiated by extrinsic carcinogenic agents such as chemicals, viruses, hormones and radiation. The evidence shows that, irrespective of the initiating cause, it is this miscommunication in the region of a developing tumour and its metastases that is ultimately responsible for the emergence and progression of the disease. The article describes how this information collectively, provides a framework for designing specific novel therapeutic approaches targeting the cell and tissue interactions driving tumour metastasis and its manifold effects on the whole body.     

Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis

Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60–3.53) and 1.64 (95% CI 1.02–2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63–1.13) for CM and 1.03 (95% CI 0.95–1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.