title: Clinicopathological and prognostic significance of hypoxia-inducible factor-1α in esophageal squamous cell carcinoma: a meta-analysis.
abstract: Published literatures on the prognostic value of hypoxia-inducible factor-1α (HIF-1α) overexpression in esophageal squamous cell carcinoma (ESCC) are conflicting and heterogeneous. We performed a meta-analysis to more precisely evaluate the clinicopathological and prognostic value of HIF-1α in patients with ESCC. Searches were applied to MEDLINE, Pubmed, Embase, Cochrane Library, Web of Science, and Chinese BioMedical Literature Databases until September 10, 2013, without language restrictions. The pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95 % confidence intervals (CIs) were used to estimate the effects. Twelve studies with 942 ESCC patients were selected to evaluate the correlation between HIF-1α and overall survival (OS), disease-free survival (DFS), response to chemoradiation (RC), and clinicopathological features. HIF-1α overexpression was significantly associated with poor OS (HR 1.78, 95% CI 1.41-2.24), DFS (HR 1.91, 95% CI 1.15-3.18), and RC (HR 3.56, 95% CI 1.68-7.53). Besides, HIF-1α overexpression was significantly associated with stage (OR 2.90, 95% CI 1.97-4.27), lymph node metastasis (OR 1.86, 95% CI 1.39-2.49), depth of invasion (OR 2.45, 95% CI 1.24-4.86), lymphatic invasion (OR 2.28, 95% CI 1.46-3.56), distant metastasis (OR 2.04, 95% CI 1.19-3.50), and vascular endothelial growth factor (OR 3.67, 95% CI 1.81-7.46). Our results indicate that HIF-1α overexpression can potently predict the poor prognosis and chemoradiation resistance for ESCC. Large prospective studies with multivariable survival analyses are now needed to confirm the clinical utility of HIF-1α as an independent prognostic marker.
authors.affiliation: Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, Hubei, 430030, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ping
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.forename: Yukun
authors.initials: Y
authors.lastname: Zu
authors.forename: Wenshu
authors.initials: W
authors.lastname: Chen
authors.forename: Xiangning
authors.initials: X
authors.lastname: Fu
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology*; D000077277:Esophageal Squamous Cell Carcinoma; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000502:physiology*; D011379:Prognosis; D017594:Publication Bias; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology
chemical_list: D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D042461:Vascular Endothelial Growth Factor A