Prognostic Value Of Hypoxia-Inducible Factor-1 Alpha In Nasopharyngeal Carcinoma: A Meta-Analysis

Background: Over the past 5 years, many studies have reported the prognostic value of hypoxia-inducible factor-1 alpha (HIF-1 alpha) in nasopharyngeal carcinoma. However, the results have not reached a consensus until now. Therefore, we performed this meta-analysis to investigate the influence of HIF-1 alpha expression on the prognosis and clinical characteristics in nasopharyngeal carcinoma. Methods: We searched PubMed, the Cochrane Library, Embase (via Ovid interface), Web of Science, and China National Knowledge Infrastructure electronic databases from their establishment to 6 December 2017. We calculated the hazard ratio (HR) and the odds ratio (OR) to assess the prognostic and clinicopathological values of HIF-1 alpha, respectively. Q test and I-2 statistic were applied to evaluate heterogeneity. We also conducted publication bias and sensitivity analyses. Results: A total of 18 studies with 1476 patients were included in our meta-analysis. We found HIF-1 alpha expression was associated with poor overall survival (HR=1.77; 95% confidence interval (CI) 1.35, 2.32; P<0.001), poor progression-free survival (HR=1.72; 95% CI 1.22, 2.44; P=0.002), a higher rate of lymph node metastasis (OR=3.81; 95% CI 2.60, 5.58, P<0.001), and more advanced tumor stage (OR=2.98; 95% CI 1.79, 4.97; P<0.001). Conclusions: Our study demonstrated that HIF-1 alpha could be an appropriate prognostic biomarker for nasopharyngeal carcinoma patients.