| Background:Gynecological cancer is characterized by tumor hypoxia.However,the role of hypoxia-inducible factor 1α(HIF-1α)in gynecological cancer remains unclear.Method:Electronic databases including Cochrane Library,PUBMED,Web of Knowledge and clinical trial registries were searched from inception through October 2014 for published,case-control studies assessing the association between HIF-1α and the clinicopathological characteristics of gynecological cancer.We pooled results from 59 studies using fixed or random-effects models and present results as odds ratios(ORs)following the PRISMA guidelines.Results:Our meta-analysis,which included 6,612 women,demonstrated that the expression of HIF1α was associated with the clinicopathological characteristics of gynecological cancer.The expression of HIF-1α in cancer or borderline tissue was significantly higher than that in normal tissue(cancer vs.normal: odds ratio(OR)=9.59,95% confidence interval(CI): 5.97,15.39,p<0.00001;borderline vs.normal: OR=4.13,95%(CI): 2.43,7.02,p<0.00001;cancer vs.borderline: OR=2.70,95%(CI): 1.69,4.31,p<0.0001).The expression of HIF-1α in III IV stage or lymph nodemetastasis was significantly higher than that in I II stage or that without lymph node metastasis,respectively(OR=2.66,95%(CI): 1.87,3.79,p<0.00001;OR= 3.98,95%(CI): 2.10,12.89,p<0.0001).HIF-1α was associated with histological grade of cancer(Grade 3 vs.Grade 1: OR=3.77,95%(CI): 2.76,5.16,p<0.00001;Grade 3 vs.Grade 2: OR=1.62,95%(CI): 1.20,2.19,p=0.002;Grade 2 vs.Grade 1: OR=2.34,95%(CI): 1.82,3.00,p<0.00001),5-years disease free survival(DFS)rates(OR=2.93,95%(CI):1.43,6.01,p=0.001)and 5-years overall survival(OS)rates(OR=5.53,95%(CI): 2.48,12.31,p<0.0001).Conclusion:HIF-1α is associated with the malignant degree,FIGO stage,histological grade,lymph node metastasis,5-years survival rate and recurrence rate of gynecological cancer.It may play an important role in clinical treatment and prognostic evaluation. |
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