Background Vitamin D has antineoplastic effects, but the synthesis of vitamin D requires ultraviolet radiation, a known risk factor for melanoma. Objective To investigate the correlations between serum vitamin D levels and risk and prognosis of melanoma. Methods A systematic review and meta-analysis were conducted. Online databases were searched on 31 Oct 2018. Results Twenty-five studies with a total of 11166 patients with melanoma were included. There was no significant difference in serum vitamin D levels between patients with melanoma and controls [standardized mean difference (SMD), À0.185; 95% confidence interval (CI), À0.533 to 0.162]. However, the prevalence of vitamin D deficiency was significantly higher in patients with melanoma than that in controls (odds ratio, 2.115; 95% CI, 1.151-3.885). In terms of prognosis, serum vitamin D levels were significantly higher in melanoma patients with lower Breslow thickness (≦1 vs. >1 mm: SMD, 0.243; 95% CI, 0.160-0.327). Moreover, melanoma patients with lower vitamin D levels had a significantly higher mortality rate (hazard ratio, 1.558; 95% CI, 1.258-1.931). Conclusions Vitamin D deficiency is associated with higher Breslow thickness and mortality in melanoma patients.

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Purpose. To compare the clinical characteristics and treatment outcome between benign and malignant lacrimal sac tumors. Methods. We retrospectively reviewed the medical records of all patients with pathologically confirmed lacrimal sac lesions from 1995 to 2018 in a tertiary medical center. Results. Among 65 eligible cases, 46 (70.8%) were benign lacrimal sac tumors and 19 (29.2%) were malignant lacrimal sac tumors. Secondary malignancy from nasal or paranasal cancer accounted for 47% of malignant lacrimal sac tumors. The patient’s mean age at the time of diagnosis was 60 years in the benign group and 48 years in the malignant group (p=0.03). The most common presenting symptoms were a palpable lump/mass and epiphora in both groups. Palpable mass extending above the medial canthal tendon was noted in 9% of the benign group and in 74% of the malignant group, respectively (p<0.001). Bloody tears were noted in 5% of the benign group and in 20% of the malignant group (p=0.21). In the malignant group, 10 (52.6%) were primary tumors and 9 (47.4%) were secondary tumors. The primary sites of the metastatic tumor to the lacrimal sac area were mostly from neighboring paranasal sinuses and nasal cavity. The recurrence rate was higher in patients with malignant tumors, as compared to the benign tumors (42% and 6%, respectively, p=0.001). The metastatic rate was 47% and the mortality rate was 53% in malignant lacrimal sac tumors. Conclusion. Although benign and malignant lacrimal sac tumors may present similar initial symptoms, timely diagnosis and intervention for malignant lacrimal sac lesions are important because they tend to be infiltrating tumors with a poor outcome.

We aimed to examine the correlations between vitamin D deficiency, severity of dry eye symptoms and primary Sjögren's syndrome (pSS) by performing a systematic review and meta-analysis. Online databases (PubMed, Cochrane Library, and Embase) were searched to identify controlled studies comparing (1) severity of dry eye symptoms between participants with and without vitamin D deficiency; and (2) serum vitamin D levels between patients with and without pSS. Eighteen studies were included. Overall, individuals with vitamin D deficiency had shorter tear breakup time (TBUT), lower Schirmer's test scores and higher ocular surface disease index (OSDI) score than those without vitamin D deficiency. Additionally, serum vitamin D levels were found to be lower in pSS than controls. Our findings highlight the importance of vitamin D deficiency in the severity of dry eye symptoms and pSS.

Background We aimed to perform a systematic review and meta-analysis of studies assessing the homeostasis model assessment for insulin resistance (HOMA-IR) values, serum adiponectin, leptin and resistin levels in patients with systemic lupus erythematosus (SLE). Method Online databases were searched on 31 March 2019 in order to identify studies comparing HOMA-IR, serum adiponectin, leptin and resistin levels between patients with SLE and controls. A random-effects model was adopted. Results Fifty-six studies involving a total of 4460 patients with SLE were included. Patients with SLE had significantly higher HOMA-IR values (standardized mean difference (SMD)=0.425; 95% confidence interval (CI) 0.156–0.693; I2=93.8%) than the control group. The serum levels of adiponectin (SMD=0.547; 95% CI 0.219–0.874; I2=90.1%), leptin (SMD=0.843; 95% CI 0.454–1.231; I2=94.4%) and resistin (SMD=0.856; 95% CI 0.199–1.513; I2=96.6%) were all higher among patients with SLE than controls. A meta-regression analysis revealed that the serum resistin level was positively correlated with disease activity (coefficient 0.123; 95% CI 0.051–0.195; p<0.001). Conclusion Patients with SLE have higher HOMA-IR values and serum levels of adiponectin, leptin and resistin than individuals without SLE. The serum level of resistin correlates with SLE disease activity.