Protein expression of hypoxia-inducible factor-1 alpha and hepatocellular carcinoma: a systematic review with meta-analysis.
OBJECTIVE
To investigate the relationship of protein expression of hypoxia-inducible factor-1 alpha (HIF-1α) with clinicopathological factors and prognosis of hepatocellular carcinoma (HCC).


METHODS
PubMed and Embase were searched from their inception through August 2013 for studies that reported the association between protein expression of HIF-1α and HCC. Random effects meta-analyses were used to summarize the odds ratios (ORs) and 95% confidence intervals (CIs).


RESULTS
Eight studies involving 851 patients with HCC were included. Protein expression level of HIF-1α was not found to be related with capsule formation, cirrhosis, tumor size, and tumor differentiation of HCC, except vascular invasion. The positive association between HIF-1α expression and vascular invasion of HCC was statistically significant (OR: 2.04, 95% CI: 1.31-3.18). As a prognostic factor, a high level of HIF-1α expression would be associated with a poor disease-free survival (OR: 2.10, 95% CI: 1.48-2.97).


CONCLUSIONS
Higher level of HIF-1α expression may indicate a bigger possibility of vascular invasion and a poorer prognosis of HCC.
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Shiyi
S
Cao
Department of General Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Shengli
S
Yang
Department of General Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Chao
C
Wu
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Yunxia
Y
Wang
Department of Hepatobiliary Surgery, Affiliated Hospital of Guiyang Medical College, Guizhou, People's Republic of China. Electronic address: jjx731003@163.com.
Jianxin
J
Jiang
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China. Electronic address: zuxunlu@yahoo.com.
Zuxun
Z
Lu
D006528:Carcinoma, Hepatocellular / Q000378:metabolism*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000096:biosynthesis*; D008113:Liver Neoplasms / Q000378:metabolism*
D051795:Hypoxia-Inducible Factor 1, alpha Subunit