Prognostic Significance of HIF-1α Expression in Hepatocellular Carcinoma: A Meta-Analysis

Aim: Pilot studies have evaluated the correlation between hypoxia-inducible factor-1 alpha (HIF-1 alpha) overexpression and clinical outcome in hepatocellular carcinoma (HCC) patients. However, the results remain inconclusive. To comprehensively and quantitatively summarize the evidence on the suitability of HIF-1 alpha to predict the prognosis of patients with HCC, a meta-analysis was carried out. Methods: Systematic literature searches were applied to PubMed, Elsevier and Web of Science databases until Feb. 2013. Seven studies (953 patients) were included in this meta-analysis. Pooled measure was calculated from the available data to evaluate the association between tissue -based HIF-1 alpha level and overall survival (OS) and disease-free survival (DFS) in HCC patients. The relation between HIF-1 alpha expression and vascular invasion was also assessed. Data were synthesized with fixed or random effect model, hazard ration (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Result: The combined data suggested that HIF-1 alpha overexpression in HCC correlated with poor OS [HR = 1.65 (95% (CI): 1.38, 1.97)] and DFS [HR = 2.14 (95% CI: 1.39, 3.29)]. And high HIF-1 alpha expression tended to be associated with vascular invasion [OR = 2.21 (95% CI: 1.06, 4.57)]. Conclusion: HIF-1 alpha overexpression indicates a poor prognosis for patients with HCC, it may also have predictive potential for HCC invasion and metastasis.