The clinicopathologic significance of hypoxia inducible factor 1 alpha expression in ovarian serous tumors

Aim: The hypoxia-inducible factor (HIF) is an alpha (α) / beta (β) heterodimeric DNA binding complex and directs an extensive transcriptional response involving the induction of genes relevant to tumor progression, such as angiogenesis, glucose/energy metabolism, cellular growth, metastasis, and apoptosis. HIF-1α has also emerged as an attractive target for cancer therapy. The aim of this study is to investigate the association between tissue HIF-1α expression, prognostic significance, and the clinicopathologic features of ovarian serous tumors. Materials and Methods: HIF-1α expression was studied by immunohistochemistry (IHC) in a total of 82 formalin-fixed, paraffin-embedded specimen of ovarian serous tumors. Results: In this series, there were 34 ovarian high-grade serous carcinoma, 12 borderline, and 36 benign serous tumors. Statistically it was determined that the expression of HIF-1α was positive, usually in carcinomas or borderline serous tumors, while it was negative in benign serous tumors (p = 0.043). The overall survival of patients with tumors that stained strongly for HIF-1α (mean 22 months) was not significantly different than that of patients with tumors that stained weakly or were negative (mean 27 months) for HIF-1α (p = 0.812). Conclusion: The results suggest that the role of hypoxia may change according to the aggressive and invasive natures of ovarian tumors. In addition the present findings demonstrated the presence of a correlation between HIF-1α expression and serous carcinomas. Therefore expression of HIF-1α may also confer chemoresistance in high-grade serous carcinomas.

Ovary; HIF-1α; Serous tumors; Borderline; Serous carcinomas

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