Abstract
Obstructive sleep apnea (OSA) up-regulates the programmed cell death-1 receptor and its ligand (PD-L1) pathway, potentially compromising immunosurveillance. We compared circulating levels of soluble PD-L1 (sPD-L1) in patients with cutaneous melanoma (CM) according to the presence and severity of OSA, and evaluated relationships with tumour aggressiveness and invasiveness.
In a multicenter observational study, 360 patients with CM underwent sleep studies, and serum sPD-L1 levels were assayed by ELISA. CM aggressiveness indices included mitotic rate, Breslow index, tumour ulceration, Clark level and tumour stage, and sentinel lymph node (SLN) metastasis was recorded as a marker of invasiveness.
sPD-L1 levels were higher in severe OSA compared to mild OSA or non-OSA patients. In OSA patients, sPD-L1 levels correlated with Breslow index and were higher in patients with tumour ulceration, advanced primary tumour stages or with loco-regional disease. The incorporation of sPD-L1 to the classic risk factors to SLN metastasis led to net improvements in the classification of 27.3%.
Thus, sPD-L1 levels are increased in melanoma patients with severe OSA and, in addition, might serve as a potential biomarker of CM aggressiveness and invasiveness in this group of subjects.
Footnotes
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Conflict of interest: Cubillos-Zapata has nothing to disclose.
Conflict of interest: Martínez-García has nothing to disclose.
Conflict of interest: Campos-Rodríguez has nothing to disclose.
Conflict of interest: de la Torre has nothing to disclose.
Conflict of interest: Nagore has nothing to disclose.
Conflict of interest: Martorell-Calatayud has nothing to disclose.
Conflict of interest: Blasco has nothing to disclose.
Conflict of interest: Vives has nothing to disclose.
Conflict of interest: Abad-Capa has nothing to disclose.
Conflict of interest: Montserrat has nothing to disclose.
Conflict of interest: Cabriada-Nuño has nothing to disclose.
Conflict of interest: Cano-Pumarega has nothing to disclose.
Conflict of interest: Corral-Peñafiel has nothing to disclose.
Conflict of interest: Diaz-Cambriles has nothing to disclose.
Conflict of interest: Mediano has nothing to disclose.
Conflict of interest: Somoza-González has nothing to disclose.
Conflict of interest: Dalmau-Arias has nothing to disclose.
Conflict of interest: Almendros has nothing to disclose.
Conflict of interest: Farré has nothing to disclose.
Conflict of interest: López-Collazo has nothing to disclose.
Conflict of interest: Gozal has nothing to disclose.
Conflict of interest: García-Río has nothing to disclose.
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