Prognostic role of hypoxia-inducible factor-1 alpha expression in osteosarcoma: a meta-analysis
Authors Ren H, Zhang Y, Li HY, Xie T, Sun LL, Zhu T, Wang SD, Ye ZM
Received 31 August 2015
Accepted for publication 20 January 2016
Published 14 March 2016 Volume 2016:9 Pages 1477—1487
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Ram Prasad
Peer reviewer comments 3
Editor who approved publication: Professor Jianmin Xu
Hai-Yong Ren,1 Yin-Hua Zhang,1,2 Heng-Yuan Li,1 Tao Xie,1 Ling-Ling Sun,1 Ting Zhu,1 Sheng-Dong Wang,1 Zhao-Ming Ye1
1Department of Orthopaedics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 2The First Department of Orthopaedics, Hospital of Zhejiang General Corps of Armed Police Forces, Jiaxing, People’s Republic of China
Background: Hypoxia-inducible factor-1α (HIF-1α) plays an important role in tumor progression and metastasis. A number of studies have investigated the association of HIF-1α with prognosis and clinicopathological characteristics of osteosarcoma but yielded inconsistent results.
Method: Systematic computerized searches were performed in PubMed, Embase, and Web of Science databases for relevant original articles. The pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated to assess the prognostic value of HIF-1α expression. The standard mean difference was used to analyze the continuous variable.
Results: Finally, nine studies comprising 486 patients were subjected to final analysis. Protein expression level of HIF-1α was found to be significantly related to overall survival (HR =3.0; 95% CI: 1.46–6.15), disease-free survival (HR =2.23; 95% CI: 1.26–3.92), pathologic grade (OR =21.33; 95% CI: 4.60–98.88), tumor stage (OR =10.29; 95% CI: 3.55–29.82), chemotherapy response (OR =9.68; 95% CI: 1.87–50.18), metastasis (OR =5.06; 95% CI: 2.87–8.92), and microvessel density (standard mean difference =2.83; 95% CI: 2.28–3.39).
Conclusion: This meta-analysis revealed that overexpression of HIF-1α is a predictive factor of poor outcomes for osteosarcoma. HIF-1α appeared to play an important role in prognostic evaluation and may be a potential target in antitumoral therapy.
Keywords: HIF-1α, osteosarcoma, prognosis, meta-analysis
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