Abstract
BackgroundCurrent reports on the prognostic and predictive value of hypoxia-inducible factor-1α (HIF-1α) in endometrial carcinoma are inconsistent. Therefore, we conducted this meta-analysis to precisely evaluate the association of HIF-1α expression with susceptibility, clinical features, and prognosis of endometrial cancer.MethodsEligible studies that assessed the role of HIF-1α protein expression, immunohistochemistry detection, disease susceptibility, clinical features, and prognosis of endometrial cancer were searched from the Embase, Pubmed, and Web of Science databases. Stata 14.0 software was used to merge and compute pooled hazard ratios (HR) and odds ratios (OR). Information including HIF-1α protein expression and clinical progression of endometrial cancer was extracted. The pooled HR and OR with corresponding 95% confidence intervals (CI) were used to estimate the strength of these associations.ResultsA total of 25 studies were included in the analysis. HIF-1α protein expression in endometrial cancer tissue was significantly higher than that in normal tissues (OR = 15.79, 95% CI = 8.44–29.52, P < 0.05). Endometrial cancer patients with higher HIF-1α protein expression had poorer prognosis compared to patients with low HIF-1α protein expression (HR = 2.29, 95% CI = 1.68–2.90, P < 0.05). In addition, high HIF-1α protein expression was significantly associated with endometrial cancer grade, lymph node metastasis, and myometrial invasion (grade in Caucasians: OR = 3.09, 95% CI = 1.63–5.85, P < 0.05; lymph node metastasis: OR = 3.09, 95% CI = 1.63–5.85, P < 0.05; myometrial invasion: OR = 2.26, 95% CI = 2.15–5.08, P < 0.05).ConclusionsHIF-1α overexpression was significantly associated with increased risk, advanced clinical progression, and poor prognosis in endometrial cancer patients.
Highlights
According to Global Cancer Statistics 2018, endometrial cancer is the sixth most common tumor and the 11th leading cause of death in women worldwide with 382,069 new cases and 89,929 deaths in 2018 [1]
hypoxiainducible factor-1a (HIF-1a) protein expression in endometrial cancer tissue was significantly higher than that in normal tissues (OR = 15.79, 95% confidence intervals (CI) = 8.44–29.52, P < 0.05)
Endometrial cancer patients with higher HIF-1a protein expression had poorer prognosis compared to patients with low HIF-1a protein expression (HR = 2.29, 95% CI = 1.68–2.90, P < 0.05)
Summary
According to Global Cancer Statistics 2018, endometrial cancer is the sixth most common tumor and the 11th leading cause of death in women worldwide with 382,069 new cases and 89,929 deaths in 2018 [1]. The authors classified endometrial cancers into four categories: copy-number high (with poor 5-year progression-free survival rate), DNApolymerase epsilon (POLE) (ultra-mutated, with >95% progression-free survival rate), microsatellite instability hypermutated, and copy-number low (microsatellite stable) [8]. This reclassification reveals that different endometrial carcinomas had different molecular characteristics that might affect postsurgical adjuvant treatment for women with aggressive tumors [8]. Current reports on the prognostic and predictive value of hypoxia-inducible factor-1a (HIF-1a) in endometrial carcinoma are inconsistent We conducted this meta-analysis to precisely evaluate the association of HIF-1a expression with susceptibility, clinical features, and prognosis of endometrial cancer
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