TALYA AKATA, GÜLDEN DİNİZ, PINAR ÖKSÜZ, YETKİN KOCA, SAMİR ABDULLAZADE
Anatolian Journal of General Medical Research - 2025;35(1):65-73
OBJECTIVE The alpha subunit of hypoxia-inducible factor-1 (HIF-1α) activates glucose transport, glycolytic enzymes, and transcription of genes encoding vascular endothelial growth factor (VEGF). HIF-1α expression is a mechanism by which tumor cells adapt to hypoxia. Gastric cancer is one of the most common cancers world-wide and has the highest mortality rate. Because patients are usually in their advanced stages at the time of diagnosis, the survival rates are low. The present study aimed to evaluate the prognostic significance of tissue expression of HIF-1α in gastric adenocarcinomas. METHODS In this study, immunohistochemical HIF-1α expression was analyzed in gastrectomy materials from 114 gastric adenocarcinomas. RESULTS HIF-1α expression was detected in 24 cases (21.1%). One (p=0.02) and five-year (p=0.03) survival rates were higher in cases with HIF-1α expression. In the regression analysis, the risk of death was 3.42 times higher in patients with advanced pathologic tumor stages (pT3 and pT4). Age, sex, tumor size, tumor location, lymphovascular and perineural invasion, human epidermal growth factor receptor 2 expression, and other clinicopathological parameters were not significantly correlated with HIF-1α expression and survival. CONCLUSION It is important to identify specific prognostic markers and new targeted treatment options for gastric cancer. Despite conflicting findings, HIF-1α expression is recognized as a negative prognostic factor in many malignancies, and therapeutic agents that may be effective, especially in the HIF-1α/VEGF pathway, have been developed. However, the survival rate of patients with HIF-1 expression was higher in patients with HIF-1α expression. A greater amount of data should be retrieved from further research studies on the prognostic significance of HIF-1α expression in gastric carcinomas, especially after the standardization of immunohistochemical evaluation methods of its expression.
