Meta-analysis of immunohistochemical expression of hypoxia inducible factor-1α as a prognostic role in gastric cancer

AIM:To conduct a meta-analysis to evaluate the prognostic role of hypoxia inducible factor-1α(HIF-1α)expression in gastric cancer.METHODS:The PubMed,EMBASE,and Web of Science databases were searched systematically for all articles published in English before August,2013.Pooled effect was calculated from the available data to evaluate the association between HIF-1αexpression and 5-year overall survival and tumor clinicopathological features in gastric cancer patients.Pooled odds ratios(ORs)with95%CIs were calculated using either a fixed-effects or a random-effects model.RESULTS:Nine studies matched the selection criteria,which reported on 1103 subjects,548 of whom had HIF-1αpositive expression(50%).This meta-analysis indicated that HIF-1αpositive expression in gastric cancer correlated with lower 5-year overall survival(OR=0.36;95%CI:0.21-0.64),worse tumor differentiation(OR=0.38;95%CI:0.23-0.64),deeper invasion(OR=0.42;95%CI:0.32-0.57),higher rates of lymph node metastasis(OR=2.23;95%CI:1.46-3.40),lymphatic invasion(OR=2.50;95%CI:1.46-4.28),and vascular invasion(OR=1.80;95%CI:1.29-2.51),and higher TNM stage(Ⅲ+Ⅳ)(OR=0.31;95%CI:0.15-0.60).CONCLUSION:HIF-1αpositive expression indicates a poor prognosis for patients with gastric cancer.Further studies are required to confirm these results.