Zheng XD, Li HY, Gao SY, Wang Q, Liu JB. High hypoxia inducible factor-1α expression is associated with reduced survival in patients with breast cancer: A meta-analysis. World J Clin Oncol 2025; 16(6): 105691 [DOI: 10.5306/wjco.v16.i6.105691]
Corresponding Author of This Article
Jiang-Bo Liu, PhD, Associate Professor, Department of Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, No. 24 Jinghua Road, Luoyang 471000, Henan Province, China. jiangboliuxing@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jun 24, 2025; 16(6): 105691 Published online Jun 24, 2025. doi: 10.5306/wjco.v16.i6.105691
High hypoxia inducible factor-1α expression is associated with reduced survival in patients with breast cancer: A meta-analysis
Xue-Di Zheng, Huan-Yu Li, Si-Yu Gao, Qi Wang, Jiang-Bo Liu
Xue-Di Zheng, Huan-Yu Li, Si-Yu Gao, Qi Wang, Jiang-Bo Liu, Department of Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
Jiang-Bo Liu, Department of Breast and Thyroid Surgery, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Zheng XD, Li HY, and Liu JB acquisition of data, analysis, and interpretation of data, and drafting the article; Zheng XD, Li HY, Gao SY, Wang Q, and Liu JB interpretation of data, revising the article; Liu JB conception and design of the study, critical revision; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Henan Province Medical Science and Technology Tackling Plan Joint Construction Project, No. LHGJ20220684; and Zhengzhou University Tianjian Advanced Biomedical Laboratory Funding Project, No. BS20240101.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Bo Liu, PhD, Associate Professor, Department of Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, No. 24 Jinghua Road, Luoyang 471000, Henan Province, China. jiangboliuxing@163.com
Received: February 4, 2025 Revised: April 6, 2025 Accepted: May 13, 2025 Published online: June 24, 2025 Processing time: 136 Days and 23.1 Hours
Abstract
BACKGROUND
Hypoxia-inducible factor 1α (HIF-1α) plays a crucial role in the prognosis of breast cancer, but the current evidence remains inconclusive.
AIM
To provide comprehensive evidence about the correlation of altered HIF-1α expression with overall survival (OS) and disease-free survival (DFS) in breast cancer patients.
METHODS
A systematic search was conducted in PubMed, Embase, and Web of Science databases to collect relevant articles that were published before April 8, 2024. A meta-analysis was used to assess the impact of altered HIF-1α expression on the OS and DFS of breast cancer patients. Subgroup and sensitivity analyses were also performed in this meta-analysis.
RESULTS
This meta-analysis included 40 studies. The average percentage of breast cancer patients with high HIF-1α expression was 39.6%. The overall meta-analysis results demonstrated that high HIF-1α expression is strongly linked to poor outcomes in patients of breast cancer. Compared with low HIF-1α expression, the overall hazard ratio for OS in patients with high HIF-1α expression was 1.47 [95% confidence interval (CI): 1.29-1.69], and the overall hazard ratio for DFS was 1.82 (95%CI: 1.56-2.12). Furthermore, both OS [1.18 (95%CI: 1.01-1.38)] and DFS [1.79 (95%CI: 1.03-3.11)] were markedly shorter in triple-negative breast cancer cases with high HIF-1α expression. Subgroup analysis revealed that the antibody used to detect HIF-1α expression affected only the correlation linking HIF-1α expression to DFS in breast cancer patients (P = 0.0004). Furthermore, the sensitivity analysis demonstrates that the overall conclusions of the meta-analysis were unaffected by the removal of individual studies.
CONCLUSION
Compared to patients with low HIF-1α expression, those with high expression level had shorter OS and DFS. However, the prognostic significance of high HIF-1α expression varies across molecularly stratified breast cancer cohorts needs to be further elucidated.
Core Tip: Hypoxia is a crucial characteristic of tumors that can influence the phenotype of cancer stem cells and contribute to cancer cell invasion and metastasis, thereby significantly impacting the prognosis of cancer patients. This meta-analysis offers a more exhaustive analysis of the relationship between high hypoxia-inducible factor 1α expression and the prognosis of breast cancer patients, providing clinicians with systematic evidence about the role of high hypoxia-inducible factor 1α expression in predicting breast cancer prognosis.
