Skip Navigation LinksHome > July 2014 - Volume 24 - Issue 6 > Overexpression of Hypoxia-Inducible Factor-1α Is a Predictor...
International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000162
Cervical Cancer

Overexpression of Hypoxia-Inducible Factor-1α Is a Predictor of Poor Prognosis in Cervical Cancer: A Clinicopathologic Study and a Meta-analysis

Huang, Miaoling MD*; Chen, Qing MD*; Xiao, Jianpeng MD; Yao, Tingting MD, PhD*; Bian, Lijuan MD; Liu, Changhao MD*; Lin, Zhongqiu MD*

Supplemental Author Material
Collapse Box


Background: Published data on the prognostic value of hypoxia-inducible factor-1α (HIF-1α) expression in cervical cancer are conflicting and heterogeneous. We aimed to derive a more precise estimation of them.

Methods: We conducted a clinicopathologic study in 74 patients with early-stage cervical cancer treated through surgery and performed a meta-analysis among patients with cervical cancer of all stages to estimate the prognostic importance of HIF-1α expression for disease-free survival (DFS) and overall survival (OS). Expression of HIF-1α was evaluated through immunohistochemistry.

Results: A positive nuclear expression of HIF-1α was found in 94.6% of all specimens. There were significant associations between HIF-1α expression and International Federation of Gynecology and Obstetrics stage (P = 0.024), tumor size (P = 0.003), and anemia (P = 0.010), respectively. Log-rank tests revealed significant correlations between HIF-1α expression, International Federation of Gynecology and Obstetrics stages, tumor grade, tumor size and DFS/OS, respectively. The multivariate Cox regression analyses revealed HIF-1α overexpression and high tumor grade to be independent predictors for impaired DFS (HIF-1α overexpression: hazard ratio [HR], 2.67; 95% confidence interval [CI], 1.10–6.47; high tumor grade: HR, 5.56; 95% CI, 1.47–21.13) and OS (HIF-1α overexpression: HR, 2.57; 95% CI, 1.06–6.23; high tumor grade: HR, 6.23; 95% CI, 1.49–25.97). The results of 10 studies indicated that HIF-1α overexpression predicted poor DFS (HR, 1.98; 95% CI, 1.22–3.21) and OS (HR, 2.58; 95% CI, 1.86–3.56) for cervical cancer.

Conclusions: The present clinicopathologic study and meta-analysis showed that HIF-1α overexpression is associated with poor survival of cervical cancer and emphasized the importance of HIF-1α as a predictor for cervical cancer.

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us


For additional oncology content, visit LWW Oncology Journals on Facebook.