喉癌患者血清中SCCAg、CEA、CA19-9、CA72-4和CYFRA21-1的检测及意义

目的 分析肿瘤标志物鳞状细胞癌相关抗原(SCCAg)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)和细胞角化素蛋白19片段(CYFRA21-1)在喉癌患者血清中的表达及意义.方法 以接受手术治疗的喉癌患者112例为研究对象,设为观察组,另抽取50例健康体检者为对照组,比较两组患者血清中肿瘤标志物的水平.结果 观察组喉癌患者术前血清中的SCCAg、CEA、CA19-9、CA72-4、CYFRA21-1水平,均显著高于对照组和术后(P<0.05);高～中分化喉癌患者血清肿瘤标志物水平显著低于低分化者(P<0.05);TNM分期Ⅰ～Ⅱ期者血清肿瘤标志物水平显著低于Ⅲ～Ⅳ期者(P<0.05);血清肿瘤标志物SCCAg、CEA、CA19-9、CA72-4、CYFRA21-1中,CYFRA21-1敏感度最高,其次为SCCAg、CEA,CA19-9最低;CA19-9特异度最高,其次为CA72-4、CEA,CYFRA21-1最低;SCCAg+ CYFRA21-1两项联合检测与五项联合检测的敏感度均显著高于单项检测,特异度低于单项检测(P<0.05),五项联合检测的敏感度高于SCCAg+ CYFRA21-1两项联合检测,特异度低于两项联合检测,但差异无统计学意义(P>0.05).结论 血清肿瘤标志物SCCAg、CEA、CA19-9、CA72-4、CYFRA21-1检测在喉癌患者的早期辅助诊断中具有一定的价值,其中CYFRA21-1和SCCAg的诊断价值最高.     

宫颈癌患者治疗前联合检测血清CYFRA21-1和SCCAg的临床意义

背景与目的：细胞角蛋白19片段抗原21—1（cytokeratin 19 fragment antigen21．1,CYFRA21-1）可用于细胞角蛋白19片段的定量检测,可作为多种恶性肿瘤的标记物。本研究旨在探讨宫颈癌患者治疗前血清CYFRA21—1和鳞状细胞癌抗原（squamous cell carcinoma antigen,SCCAg）联合检测对宫颈癌诊断的意义及其与临床病理特征的相关性。方法：对100例宫颈癌患者行治疗前血清CYFRA21．1及SCCAg检测,以20例健康妇女为对照,分析其作为诊断参考的特异性和敏感性,并对两者与宫颈癌临床病理特征的相关性进行单因素和多因素分析。结果：CYFRA21-1、SCCAg用于宫颈癌诊断的特异性均为100％。CYFRA21-1、SCCAg升高用于治疗前诊断的敏感性分别为36．0％和47．0％．两者差异无统计学意义（P〈0．05）。两者联合检测的敏感性达到60．0％,与CYFRA21-1单一指标相比,其差异有统计学意义（P〈0．05）。单因素分析示CYFRA21-1升高与FIGO分期、肿瘤大小相关：SCCAg升高与病理类型、肿瘤大小、宫颈深肌层浸润及盆腔淋巴结转移相关。多因素分析未发现与CYFRA21-1升高显著相关的临床病理因素：与SCCAg升高显著相关的因素为宫颈深肌层浸润和盆腔淋巴结转移。SCCAg升高用于预测盆腔淋巴结转移和宫颈深肌层浸润的敏感性均显著高于CYFRA21—1（75．0％眦29．2％,P=0．001：55．8％US．26．9％,P=0．024）。联合检测CYFRA21—1对提高SCCAg预测盆腔淋巴结转移和宫颈深肌层浸润的敏感度其差异无统计学意义（79．2％US．75．0％,P〉0．05;63．5％vs．55．8％,P〉0．05）。结论：CYFRA21-1对预测盆腔淋巴结转移、宫颈深肌层浸润的价值不及SCCAg。对于宫颈鳞癌患者,SCCAg是首选的肿瘤标志物。     

CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值研究

目的 探讨血清细胞角质蛋白19片段CYFRA21-1、糖类抗原19-9(CA19-9)、鳞状细胞癌抗原(SC-CAg)单独及联合检测在食管癌诊断中的价值.方法 选取100例食管癌患者(观察组)和50例健康志愿者(对照组),检测两组受试者的血清CYFRA21-1、CA19-9和SCCAg水平,并按照临床分期对观察组患者进行亚组分析,采用受试者工作曲线(ROC)分析CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值.结果 观察组患者的血清CYFRA21-1、CA19-9和SCCAg水平均明显高于对照组,Ⅰ~Ⅱ期患者的血清CYFRA21-1、CA19-9和SCCAg水平均明显低于Ⅲ~Ⅳ期,差异均有统计学意义(P﹤0.01);血清CYFRA21-1、CA19-9、SCCAg三者联合检测诊断食管癌的灵敏度为82.26%,特异度为91.33%,阳性预测值为86.14%,阴性预测值为89.57%,AUC值为0.864,均高于其中任一项指标单独检测,差异均有统计学意义(P﹤0.05).结论 血清CYFRA21-1、CA19-9、SC-CAg三者联合检测可以提高食管癌诊断的灵敏度和特异度.     

血清CYFRA21-1、CEA联合检测在诊断复发性子宫颈鳞癌中的价值

目的探讨CYFRA 21-1、CEA在辅助诊断子宫颈鳞癌治疗后复发的临床价值,为复发性子宫颈鳞癌的诊断及预后评估提供有临床价值的肿瘤标志物。方法采用ES300全自动酶免疫分析仪检测51例治疗后临床证实复发或远处转移患者、36例治疗后无瘤生存患者、17例子宫良性肿瘤和31例健康女性血清CYFRA 21-1、CEA水平。结果(1)51例治疗后复发或远处转移患者CYFRA 21-1平均值为(6.18±3.67)μg/L,CEA平均值为(5.09±2.71)μg/L,显著高于治疗后无瘤生存患者、子宫颈良性病变患者及健康人。如确定CYFRA 21-1的界定值为3.3μg/L,其诊断子宫颈癌复发的灵敏度为76.4%(39/51);以CEA 3.4μg/L为界定值,其诊断子宫颈鳞癌复发的灵敏度为52.9%(27/51)。两者联合检测的灵敏度为88.2%(45/51)。(2)复发子宫颈癌患者经综合治疗后,CYFRA 21-1、CEA均有所下降,两者下降的幅度与疗效相关,但与治疗前水平无关。(3)36例治疗后无瘤生存患者CYFRA 21-1高于限定值者5例,假阳性率13.9%(5/36),CEA高于限定值者3例,假阳性率8.3%(3/36);17例子宫颈良性病变测定值CYFRA 21-1高于限定值者2例,假阳性率11.7%(2/17),CEA无高于限定值者;31例健康女性血清中CYFRA 21-1无高于限定值者,CEA高于限定值者1例,假阳性率3.2%(1/31)。结论CYFRA 21-1和CEA的联合检测为复发性子宫颈癌的诊断、疗效评价、随访及预测预后提供了有价值的肿瘤标志物。     

血清CEA、SCC和CYFRA21-1在食管癌放、化疗前后的变化

目的:研究食管癌放、化疗前后血清癌胚抗原(CEA)、鳞状上皮细胞癌相关抗原(SCC)和细胞角化素蛋白片段(CYFRA21-1)的变化.方法:选2014年至2016年接受放化疗的食管癌100例作为研究组,健康体检者26例为对照组.采用酶联免疫吸附法(ELISA)检测患者血清治疗前、后CEA、SCC、CYFRA21-1水平,分析治疗前后的变化,以及与病理类型、肿瘤浸润度、TNM分期的关系.结果:治疗前研究组血清CEA、SCC、CYFRA21-1水平均明显高于对照组(P<0.05),治疗后研究组均有明显下降(P<0.05);与不同病理分期、肿瘤浸润深度、TNM分期差异明显,其中Ⅲ期、T 4期最高(P<0.05).但与对照组比较无差异(P>0.05).结论:血清CEA、SCC、CYFRA21-1在不同病理分期、TNM分期及放化疗前后的食管癌患者血清含量不同,对于食管癌患者制定个性化治疗方案以及观察疗效有重要意义.     

血清CEA、SCCA、CYFRA21-1在肺腺癌中的表达及其与预后的关系

目的探讨肺腺癌患者化疗前后血清肿瘤标志物癌胚抗原(CEA)、鳞状细胞癌抗原(SCCA)、细胞角蛋白19片段抗原(CYFRA21-1)的表达水平对化疗疗效及预后的影响。方法选择2015年2月至2017年6月福建医科大学附属宁德市医院收治84例经病理学或组织细胞学证实的肺腺癌患者为研究对象。分别测定化疗前、化疗1个周期及化疗2个周期后血清CEA、SCCA、CYFRA21-1表达水平,分析CEA、SCCA、CYFRA21-1表达与化疗疗效的关系; Kaplan-Meier法绘制生存曲线,比较CEA高表达者与CEA低表达者、SCCA高表达者与SCCA低表达者、CYFRA21-1高表达者与CYFRA21-1低表达者中位生存期的差异;Cox比例风险模型行多因素生存分析。结果与化疗前相比,化疗1个周期后、2个周期后血清CEA、SCCA、CYFRA21-1表达在部分缓解患者中较化疗前下降(P0.05);在疾病稳定患者中差异无统计学意义(P0.05);在PD患者中升高(P0.05)。Kaplan-Meier分析中位生存期,CEA高表达者(12.0个月)短于CEA低表达者(16.0个月),SCCA高表达者(12.0个月)短于SCCA低表达者(19.0个月),CYFRA21-1高表达者(12.0个月)短于CYFRA21-1低表达者(17.0个月),差异均有统计学意义(P0.05)。Cox回归分析显示治疗前血清CEA高表达者、SCCA高表达者、CYFRA21-1高表达者为预后不良因素(P0.05)。结论监测肺腺癌患者化疗前、后血清CEA、SCCA、CYFRA21-1水平有助于疗效及预后的评估。     

序贯放化疗与同步放化疗对ⅢA-N2期非小细胞肺癌的疗效比较

目的比较序贯放化疗与同步放化疗对ⅢA-N2期非小细胞肺癌的治疗效果。方法将40例ⅢA-N2期非小细胞肺癌患者按照随机数字表法分为序贯组(接受化疗序贯纵隔淋巴结放疗)与同步组(接受化疗同步纵隔淋巴结放疗),每组20例。比较两组患者的临床疗效、治疗前后的血清肿瘤标志物[糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCC-Ag)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]水平、治疗期间不良反应发生情况、无进展生存时间(PFS)和总生存时间(OS)。结果同步组患者的总有效率为75%(15/20),高于序贯组患者的35%(7/20),差异有统计学意义(P﹤0.05)。同步组患者的临床疗效优于序贯组患者,差异有统计学意义(P﹤0.05)。治疗后,同步组患者血清中的CEA、CYFRA21-1、SCC-Ag水平均低于序贯组患者,差异均有统计学意义(P﹤0.05)。两组患者的各不良反应发生率比较,差异均无统计学意义(P﹥0.05)。同步组患者的PFS、OS均长于序贯组患者,差异均有统计学意义(P﹤0.05)。结论与序贯放化疗相比,同步放化疗对于ⅢA-N2期非小细胞肺癌患者的临床疗效更优,能够有效延长患者的生存时间,且不会增加不良反应。     

同步放化疗治疗复发性宫颈癌的疗效及安全性

目的探讨同步放化疗与单纯放疗治疗复发性宫颈癌的疗效及安全性。方法将260例复发性宫颈癌患者依据治疗方式不同分为同步放化疗组(150例)和单纯放疗组(110例),单纯放疗组予以放疗,同步放化疗组在单纯放疗组的治疗基础上予以同步化疗。比较两组患者临床疗效、血清肿瘤标志物[鳞状细胞癌相关抗原(SCC-Ag)、癌胚抗原(CEA)、糖类抗原72-4(CA72-4)]水平、不良反应及生存情况。结果同步放化疗组患者治疗有效率为90.00%(135/150),明显高于单纯放疗组的71.82%(79/110),差异有统计学意义(P﹤0.01)。治疗前,两组患者SCC-Ag、CEA及CA72-4水平比较,差异均无统计学意义(P﹥0.05);治疗后,两组患者SCC-Ag、CEA及CA72-4水平均降低(P﹤0.05),且同步放化疗组患者SCC-Ag、CEA及CA72-4水平均明显低于单纯放疗组(P﹤0.01)。两组患者3~4级不良反应总发生率比较,差异无统计学意义(P﹥0.05)。同步放化疗组患者3年生存率及5年生存率均明显高于单纯放疗组,差异均有统计学意义(P﹤0.01)。结论同步放化疗相较于单纯放疗治疗复发性宫颈癌具有更加显著的疗效,可降低血清肿瘤标志物水平,提高生存率,且不会明显增加不良反应。     

SCCAg与CYFRA21-1联合检测在鼻咽癌中的诊断价值

目的:探讨血清鳞状细胞癌相关抗原（SCCAg）、细胞角蛋白19片段（CYFRA21-1）联合检测在鼻咽癌诊断中的价值。方法:收集120例广西医科大学肿瘤医院2011-2014年确诊的鼻咽癌患者血清120例,所有患者均按鼻咽癌08分期标准分期。采用酶联免疫检测法和化学发光法检测SCCAg和CYFRA21-1表达水平。结果:鼻咽癌患者血清SCCAg阳性表达率为15.0%。在T分组中P＞0.05,N分组中P＞0.05,差异均无统计学意义,在M分组中P＜0.05,差异有统计学意义。鼻咽癌患者血清CYFRA21-1阳性表达率为55.8%,在T、N、M分组中均P＜0.05,差异均有统计学意义,CYFRA21-1与鼻咽癌分期有相关性。SCCAg、CYFRA21-1两者联合检查阳性表达率为66.7%,对两者进行相关性检测,差异无统计学意义（P＞0.05）。结论:SCCAg作为鼻咽癌的筛查指标阳性率偏低,而对鼻咽癌是否发生远端转移有一定的临床意义。CYFRA21-1与鼻咽癌临床分期关系密切,可作为诊断鼻咽癌筛选的辅助指标,动态监测CYFRA21-1水平有助于鼻咽癌患者的病情监控,可判断是否出现淋巴结及远端转移。两者联合检测可以提高检出阳性率,并对预测鼻咽癌的远处转移更有临床意义。     

肺癌血清肿瘤标志物对肺癌早期诊断和治疗的临床意义

目的检测神经元特异性烯醇化酶(NSE)、血清癌胚抗原(CEA)、细胞角蛋白19片段抗原(cytokeratin 19 fragment antigen,CYFRA21-l)、糖类抗原-125(CA125)和糖类抗原-153(CA153)水平,探讨其在肺癌早期诊断和治疗中的临床意义。方法检测87例肺癌患者、50例肺部良性疾病患者和30例健康人血清中NSE、CEA、CA125、CYFRA21-1和CA153的水平。结果肺癌组血清中NSE、CEA、CYFRA21-1、CA125、CA153水平明显高于良性肺部疾病组和健康对照组,差异有统计学意义(P<0.01),而肺良性病变组和健康对照组血清中NSE、CEA、CYFRA21-1、CA125、CA153水平差异无统计学意义(P>0.05);复发组患者血清中NSE、CEA、CYFRA21-1、CA125、CA153水平明显高于未复发组,差异有统计学意义(P<0.01)。5项指标联合检测能明显提高肺癌诊断的敏感性,与单独各项指标敏感性比较差异具有统计学意义(P<0.01)。结论肺癌血清肿瘤标志物在肺癌早期诊断和治疗中具重要的临床价值,并且肿瘤标志物联合检测可以提高肺癌诊断的敏感性。     

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.