Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma A Multicenter Observational Study in 443 Patients
Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma A Multicenter Observational Study in 443 Patients
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DOI：
10.1016/j.chest.2018.07.015
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发表时间：
2018-12-01
期刊：
影响因子：
9.6
通讯作者：
Gozal, David
中科院分区：
文献类型：
--
作者：
Angel Martinez-Garcia, Miguel;Campos-Rodriguez, Francisco;Gozal, David
背景技术背景：睡眠呼吸障碍（SDB）与癌症的发病率和死亡率较高有关，尽管这些发现不一致。然而，目前还没有大型研究来调查特定类型癌症患者的这种关联。本研究旨在评估SDB的严重程度和侵略性标记物的皮肤melanoma.METHODS：四百四十三例诊断为黑色素瘤的患者在6个月内诊断进行了睡眠研究之间的潜在关系。收集一般人口统计学资料，沿着黑色素瘤特征和多导生理参数，包括呼吸暂停低通气指数（AHI）和连续和间歇性夜间氧合血红蛋白去饱和指数（DI 4%）。SDB与各种客观黑色素瘤侵袭性标志物之间独立关系的探索结果：AHI或DI 4%上三分位数的患者为1.94在调整年龄、性别、肿瘤位置和BMI后，与这些睡眠属性的最低三分位数的人相比，患有侵袭性黑色素瘤（Breslow指数> 1 mm）的可能性分别高出1.93倍（95%CI，1.14 -3.32; P = .022）和1.93倍（95%CI，1.14-3.26; P = .013）。这种关联是特别突出的患者之间< 56 years of age with Breslow index >2 mm. The存在的侵略性的其他标志物也与较高的AHI和DI4% value.CONCLUSIONS：SDB的严重程度是独立的皮肤黑色素瘤的侵略性更大，特别是在年轻患者。
BACKGROUND: Sleep-disordered breathing (SDB) has been associated with a greater incidence and mortality of cancer, although such findings are inconsistent. However, no large studies are currently available to investigate this association in patients with a specific type of cancer. This study seeks to assess potential relationships between SDB severity and aggressiveness markers of cutaneous melanoma.METHODS: Four hundred and forty-three patients with a diagnosis of melanoma underwent a sleep study within 6 months of diagnosis. General demographics were collected, along with melanoma characteristics and polygraphic parameters consisting of the apnea-hypopnea index (AHI) and indices of both continuous and intermittent night-time oxyhemoglobin desaturation (DI4%). An exploration of independent relationships between SDB and various objective melanoma aggressiveness markers (Breslow index, presence of ulceration, presence of regression, mitotic index, stage of severity, damage to the sentinel lymph, and spreading of the melanoma) was performed.RESULTS: Patients in the upper tertiles of AHI or DI4% were 1.94 (95% CI, 1.14-3.32; P = .022) and 1.93 (95% CI, 1.14-3.26; P = .013) times more likely, respectively, to present with aggressive melanoma (Breslow index > 1 mm) than those in the lowest tertiles of these sleep attributes after adjustment for age, sex, tumor location, and BMI. This association was particularly prominent among patients < 56 years of age with Breslow index > 2 mm. The presence of the additional markers of aggressiveness was also associated with higher AHI and DI4% values.CONCLUSIONS: The severity of SDB was independently associated with greater aggressiveness of cutaneous melanoma, particularly among younger patients.