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[目的]评价乳腺癌中乏氧诱导因子-1α(HIF-1α)的表达及其与临床预后的关系。[方法]计算机检索Pubmed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库等,同时追查纳入文献的参考文献,纳入有关HIF-1α与乳腺癌关系的临床试验。采用Stata 11.0软件进行统计学分析。[结果]共纳入18篇文献1503例乳腺癌患者。Meta分析结果显示:HIF-1α在乳腺癌中的阳性表达水平明显增高(OR=23.11,95%CI:10.07～53.03,P<0.001)。HIF-1α在乳腺癌T3～4期与T1～2期的表达差异无统计学意义(OR=1.21,95%CI:0.87～1.87,P=0.392);HIF-1α在乳腺癌低分化组与中高分化组(OR=3.77,95%CI:2.78～5.11,P<0.001)、淋巴结转移组与非淋巴结转移组(OR=3.03,95%CI:1.76～5.22,P<0.001)、临床分期Ⅲ～Ⅳ期组与Ⅰ～Ⅱ期组(OR=2.82,95%CI:1.94～4.10,P<0.001)的表达差异均具有统计学意义。HIF-1α的表达明显增加了乳腺癌中血管内皮生长因子(VEGF)的表达(OR=6.55,95%CI:4.33～9.68,P<0.001)。HIF-1α阳性表达乳腺癌患者的5年生存率明显低于HIF-1α阴性表达者(RR=0.54,95%CI:0.35～0.83,P<0.001)。[结论]HIF-1α在乳腺癌中高表达,增加了其恶性行为的发生风险,降低了患者的5年生存率,乳腺癌中HIF-1α与VEGF的表达有一定的相关性。
[Objective] To evaluate the expression of hypoxia-inducible factor-1α (HIF-1α) and its relationship with clinical prognosis in breast cancer. [Methods] Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database were searched by computer, and the included references were traced to include the clinical trial about the relationship between HIF-1α and breast cancer . Stata 11.0 software was used for statistical analysis. [Results] A total of 18 articles were included in 1503 breast cancer patients. Meta analysis showed that the positive expression of HIF-1α in breast cancer was significantly higher (OR = 23.11, 95% CI: 10.07-53.03, P <0.001). There was no significant difference in the expression of HIF-1αbetween T3 ~ 4 and T1 ~ 2 of breast cancer (OR = 1.21, 95% CI: 0.87-1.87, P = 0.392) (OR = 3.77, 95% CI: 2.78-5.11, P <0.001), lymph node metastasis group and non-lymph node metastasis group (OR = 3.03, 95% CI: 1.76-5.22, P <0.001) There was significant difference in the expressions of ~ Ⅳ group and Ⅰ ~ Ⅱ group (OR = 2.82, 95% CI: 1.94-4.10, P <0.001). HIF-1α expression significantly increased the expression of vascular endothelial growth factor (VEGF) in breast cancer (OR = 6.55, 95% CI: 4.33-9.68, P <0.001). The 5-year survival rate of HIF-1αpositive breast cancer patients was significantly lower than that of HIF-1a negative patients (RR = 0.54, 95% CI: 0.35-0.83, P <0.001). [Conclusion] The high expression of HIF-1α in breast cancer increases the risk of malignant behavior, reduces the 5-year survival rate of patients and the expression of HIF-1α and VEGF in breast cancer.