Prognostic Role of Hypoxic Inducible Factor Expression in Non-small Cell Lung Cancer: A Meta-analysis

Introduction: Reported prognostic roles of hypoxic inducible factor (HIF) expression in non-small cell lungcancer (NSCLC) have varied. This meta-analysis aimed to examine the relationship between HIF expressionand clinical outcome in NSCLC patients.
Methods: PubMed were used to identify relevant literature with thelast report up to December 20th, 2012. After careful review, survival data were collected from eligible studies.We completed the meta-analysis using Stata statistical software (Version 11) and combined hazard ratio (HR)for overall survival (OS). Subgroup specificity, heterogeneity and publication bias were also assessed. All of theresults were verified by two persons to ensure accuracy.
Results: Eight studies were finally stepped into thismeta-analysis in which seven had available data for HIF-1α and three for HIF-2α. Combined HRs suggested thathigher expression of HIF1α had a negative impact on NSCLC patient survival (HR=1.50; 95%CI =1.07–2.10;p=0.019). The expression of HIF-2α was also relative to a poorer survival (HR=2.02; 95%CI =1.47–2.77; p=0.000).No bias existed in either of the two groups.
Conclusion: This study suggests that elevations of HIF-1α and HIF-2α expression are both associated with poor outcome for patients with NSCLC. The data support further andhigh quality investigation of HIF expression for predicting poor outcome in patients with NSCLC.