title: The role of hypoxic-inducible factor (HIF1α) and aldolaseC protein in endometrial carcinogenesis: a retrospective study of 279 patients.
abstract: OBJECTIVE
  Hypoxia-inducible factor (HIF1α) plays an integral role in response to hypoxia, controlling dozens of target genes including aldolaseC (ALDC), an important enzyme in the glycolytic pathway. It also induces angiogenesis, allowing survival and proliferation of cancer cells. The aims of our study were to evaluate the expressions of HIF1α and ALDC in patients with endometrial cancer (EC) and define their association with disease outcome and to determine the existence of an association between HIF1α and ALDC proteins.
  
  
  METHODS
  This is a population-based retrospective cohort study using the gynaecological-oncology database. The authors identified all women with EC with adequate follow-up. Immunohistochemistry using antibodies to ALDC and HIF1α was performed on paraffin-embedded tissue from 279 patients. To test the association between ALDC /HIF1α protein using immunohistochemistry (IHC) (positive and negative) and the clinical parameters, Fisher's exact test was performed for categorical parameters and the logistic regression model was used for continuous ones. Pearson correlation was used to check the association of IHC between ALDC and HIF1α.
  
  
  METHODS
  Academic referral centre.
  
  
  METHODS
  Women with EC from 2000 to 2010 obtained from the gynaecological-oncology database.
  
  
  METHODS
  The disease outcome is defined by alive with no evidence of disease versus all other outcomes.
  
  
  RESULTS
  ALDC and HIF1α were overexpressed in the vast majority of EC cases (78% and 76%, respectively). There was a strong positive association between HIF1α and ALDC (p=0.0017). There was a significant association between ALDC and depth of myometrial invasion (p=0.0438), and between HIF1α and tumour grade (p=0.0231) and tumour subtype (p=0.018). However, there was no association between neither ALDC nor HIF1α and disease status.
  
  
  CONCLUSIONS
  ALDC and HIF1α play an important role in endometrial carcinogenesis. Their expression by the majority of EC makes inhibition of HIF1α a very attractive therapeutic option for treating patients with EC and we suggest that it will be prospectively validated in future studies.
authors.affiliation: Department of Pathology, University of Southern California, Los Angeles, California, USA.
authors.forename: Paulette
authors.initials: P
authors.lastname: Mhawech-Fauceglia
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.forename: Damanzoopinder
authors.initials: D
authors.lastname: Samrao
authors.forename: Teodulo
authors.initials: T
authors.lastname: Menesses
authors.forename: Heidi
authors.initials: H
authors.lastname: Godoy
authors.forename: Faith
authors.initials: F
authors.lastname: Ough
authors.forename: Shashikant
authors.initials: S
authors.lastname: Lele
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.forename: Tanja
authors.initials: T
authors.lastname: Pejovic