Prognosis value of HIF-1α expression in patients with non-small cell lung cancer

Gene. 2014 May 15;541(2):69-74. doi: 10.1016/j.gene.2014.03.025. Epub 2014 Mar 12.


Background: Hypoxia-inducible factor 1 (HIF-1) is a transcription factor that plays a critical role in the development and progression of tumors. Various studies evaluating the prognostic value of HIF-1α in patients with lung cancer (LC) remain controversial. To comprehensively and quantitatively summarize the evidence on the effect of HIF-1α expression on the survival of patients with LC, a meta-analysis was carried out.

Material and methods: Electronic databases were used to identify published studies before August 31st, 2013. Studies were assessed for quality using REMARK. Data were collected comparing overall survival in patients with high HIF-1α expression with those with low expression.

Results: Totally, 13 papers including 1420 patients were subjected to final analysis. The combined hazard ratio (HR) was 1.60 (95% CI: 1.14-2.25, P=0.007), suggesting that high expression of HIF-1α was an indicator of poor prognosis. Further, when stratified by LC histological type (SCLC and NSCLC), study region (Asia and Europe), cut-off values (10%), tumor stage (I-III and I-IV), antibody for IHC (H1α67 and ESEE 122), and HR estimated method (univariate/multivariate analysis), most of the results were statistically significant.

Conclusions: Taken together, this meta-analysis revealed that HIF-1α overexpression might be a predicative factor of poor prognosis for NSCLC particularly in Asia.

Keywords: HIF-1α; Lung cancer; Meta-analysis; Prognosis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neoplasm / immunology
  • Asia / epidemiology
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / immunology
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Europe / epidemiology
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / immunology
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality*
  • Prognosis
  • Transcription Factors / metabolism


  • Antibodies, Neoplasm
  • Biomarkers, Tumor
  • HIF1A protein, human
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Transcription Factors