Open Access

Expression of HIF‑1α is a predictive marker of the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer

  • Authors:
    • Bin Yan
    • Quan‑Fu Ma
    • Wen‑Fu Tan
    • Hong‑Ning Cai
    • Yan‑Li Li
    • Zhi‑Gang Zhou
    • Xuan Dai
    • Fa‑Xia Zhu
    • Yu‑Jing Xiong
    • Meng Xu
    • Yu‑Lin Guo
    • Han Gao
    • Jun‑Bo Hu
    • Xu‑Feng Wu
  • View Affiliations

  • Published online on: May 7, 2020     https://doi.org/10.3892/ol.2020.11596
  • Pages: 841-849
  • Copyright: © Yan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Platinum-based, arterial infusion chemotherapy as a neoadjuvant chemotherapy (NACT) followed by hysterectomy may be efficient for the treatment of locally advanced cervical cancer and improve prognosis. It is important to predict whether the NACT would be effective before it is launched. Hypoxia inducible factor‑1α (HIF‑1α) is the master transcriptional regulator of the cellular response to altered oxygen concentration. HIF‑1α protein expression is elevated in numerous human malignancies, contributes to poor disease outcome, and has been reported to induce tumorigenesis and chemoresistance. In the present study, patients with International Federation of Gynecology and Obstetrics stage IIB‑IIIB cervical cancer (n=59) between 2008 and 2014 were assessed for HIF‑1α expression by immunohistochemistry. Tumor samples were obtained by biopsy before any treatment. A double‑path chemotherapy regimen, paclitaxel (intravenous) plus cisplatin (intra‑arterial injection into the uterine region), was used as NACT. The patients were then separated into two groups according to NACT response: One group comprised patients with NACT, for whom the response to treatment was efficient resulting in complete/partial remission of the tumor (CR + PR group; n=52), the other group contained patients with NACT, for whom the result of the treatment was a stable/progressive disease (SD + PD group; n=7). HIF‑1α expression was tested in paraffin‑embedded sections using immunohistochemistry. HIF‑1α expression was significantly higher in the SD + PD group compared with the CR + PR group (P=0.029). The overall survival time was significantly longer in the CR + PR group compared with the SD + PD group (P<0.001). When the patients were divided into two groups based on HIF‑1α expression levels. Low (weighted score ≤4, n=39) and high (weighted score ≥6, n=20) expression level groups; the low HIF‑1α expression group was significantly more susceptible to NACT treatment (P=0.025). Cox hazard analysis revealed that a high level of HIF‑1α expression and lymph node metastases were significant independent predictors of poor overall survival (P=0.025, HR=6.354; P=0.020, HR=6.909, respectively). These results indicated that the expression of HIF‑1α may be able to predict the efficiency of NACT and may be considered an independent prognostic factor for stage IIB‑IIIB cervical cancer.

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July 2020
Volume 20 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

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APA
Yan, B., Ma, Q., Tan, W., Cai, H., Li, Y., Zhou, Z. ... Wu, X. (2020). Expression of HIF‑1α is a predictive marker of the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer. Oncology Letters, 20, 841-849. https://doi.org/10.3892/ol.2020.11596
MLA
Yan, B., Ma, Q., Tan, W., Cai, H., Li, Y., Zhou, Z., Dai, X., Zhu, F., Xiong, Y., Xu, M., Guo, Y., Gao, H., Hu, J., Wu, X."Expression of HIF‑1α is a predictive marker of the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer". Oncology Letters 20.1 (2020): 841-849.
Chicago
Yan, B., Ma, Q., Tan, W., Cai, H., Li, Y., Zhou, Z., Dai, X., Zhu, F., Xiong, Y., Xu, M., Guo, Y., Gao, H., Hu, J., Wu, X."Expression of HIF‑1α is a predictive marker of the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer". Oncology Letters 20, no. 1 (2020): 841-849. https://doi.org/10.3892/ol.2020.11596