Cubillos-Zapata, CarolinaMartínez-García, Miguel ÁngelCampos-Rodríguez, FranciscoSánchez de la Torre, ManuelNagore, EduardoMartorell-Calatayud, AntonioHernández Blasco, LuisChiner Vives, EusebiAbad-Capa, JorgeMontserrat, Josep MaríaCabriada-Nuño, ValentínCano-Pumarega, IreneCorral-Peñafiel, JaimeDiaz-Cambriles, TrinidadMediano, OlgaSomoza-González, MaríaDalmau-Arias, JoanAlmendros, IsaacFarré, RamónLópez-Collazo, EduardoGozal, DavidGarcía-Río, FranciscoSpanish Sleep Network2023-01-252023-01-252019-01-31http://hdl.handle.net/10668/13253Obstructive sleep apnoea (OSA) upregulates 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 according to the presence and severity of OSA, and evaluated relationships with tumour aggressiveness and invasiveness.In a multicentre observational study, 360 patients with cutaneous melanoma underwent sleep studies, and serum sPD-L1 levels were assayed using ELISA. Cutaneous melanoma 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 locoregional 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 cutaneous melanoma aggressiveness and invasiveness in this group of subjects.enAdultAgedAnthropometryB7-H1 AntigenBiomarkers, TumorCross-Sectional StudiesFemaleHumansLymphatic MetastasisMaleMelanomaMiddle AgedMitosisNeoplasm InvasivenessNeoplasm MetastasisObesityOverweightROC CurveRegression AnalysisRisk FactorsSkin NeoplasmsSleep Apnea, Obstructiveresearch article30487198open access10.1183/13993003.01298-20181399-3003https://erj.ersjournals.com/content/erj/53/2/1801298.full.pdf