Huang Miaoling, Chen Qing, Xiao Jianpeng, Yao Tingting, Bian Lijuan, Liu Changhao, Lin Zhongqiu
*Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University; †Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention; and ‡Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Int J Gynecol Cancer. 2014 Jul;24(6):1054-64. doi: 10.1097/IGC.0000000000000162.
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.
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.
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.
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.
关于缺氧诱导因子-1α（HIF-1α）表达在宫颈癌中的预后价值，已发表的数据相互矛盾且存在异质性。我们旨在对其进行更精确的评估。
我们对74例接受手术治疗的早期宫颈癌患者进行了临床病理研究，并对所有分期的宫颈癌患者进行了荟萃分析，以评估HIF-1α表达对无病生存期（DFS）和总生存期（OS）的预后重要性。通过免疫组织化学评估HIF-1α的表达。
在所有标本中，94.6%发现HIF-1α核阳性表达。HIF-1α表达分别与国际妇产科联盟分期（P = 0.024）、肿瘤大小（P = 0.003）和贫血（P = 0.010）之间存在显著关联。对数秩检验分别显示HIF-1α表达、国际妇产科联盟分期、肿瘤分级、肿瘤大小与DFS/OS之间存在显著相关性。多因素Cox回归分析显示，HIF-1α过表达和高肿瘤分级是DFS受损（HIF-1α过表达：风险比[HR]，2.67；95%置信区间[CI]，1.10 - 6.47；高肿瘤分级：HR，5.56；95% CI，1.47 - 21.13）和OS（HIF-1α过表达：HR，2.57；95% CI，1.06 - 6.23；高肿瘤分级：HR，6.23；95% CI，1.49 - 25.97）的独立预测因素。10项研究的结果表明，HIF-1α过表达预示着宫颈癌患者的DFS（HR，1.98；95% CI，1.22 - 3.21）和OS（HR，2.58；95% CI，1.86 - 3.56）较差。
目前的临床病理研究和荟萃分析表明，HIF-1α过表达与宫颈癌患者的不良生存相关，并强调了HIF-1α作为宫颈癌预测指标的重要性。
