Weak HIF-1alpha expression indicates poor prognosis in resectable pancreatic ductal adenocarcinoma

Abstract Background HIF-1alpha and CAIX proteins are commonly expressed under hypoxic conditions, but other regulatory factors have been described as well. Pancreatic ductal adenocarcinoma (PDAC) is characterized by hypoxia and strong stromal reaction and has a dismal prognosis with the currently av...

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Bibliographic Details
Published in:World Journal of Surgical Oncology
Main Authors: Joni Leppänen, Olli Helminen, Heikki Huhta, Joonas H. Kauppila, Joel Isohookana, Kirsi-Maria Haapasaari, Seppo Parkkila, Juha Saarnio, Petri P. Lehenkari, Tuomo J. Karttunen
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2018
Subjects:
HIF-1alpha
Carbonic anhydrase 9
Pancreatic ductal adenocarcinoma
Surgery
RD1-811
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Northern Finland
Online Access:https://doi.org/10.1186/s12957-018-1432-4
https://doaj.org/article/0dc376d4f4df491fa39525e7c811b4c6
Description
Summary:Abstract Background HIF-1alpha and CAIX proteins are commonly expressed under hypoxic conditions, but other regulatory factors have been described as well. Pancreatic ductal adenocarcinoma (PDAC) is characterized by hypoxia and strong stromal reaction and has a dismal prognosis with the currently available treatment modalities. Methods We investigated the expression and prognostic role of HIF-1alpha and CAIX in PDAC series from Northern Finland (n = 69) using immunohistochemistry. Results In our PDAC cases, 95 and 85% showed HIF-1alpha and CAIX expression, respectively. Low HIF-1alpha expression correlated with poor prognosis, and multivariate analysis identified weak HIF-1alpha intensity as an independent prognostic factor for PDAC-specific deaths (HR 2.176, 95% CI 1.216–3.893; p = 0.009). There was no correlation between HIF-1alpha and CAIX expression levels, and the latter did not relate with survival. Conclusions Our findings are in contrast with previous research by finding an association between low HIF-1alpha and poor prognosis. The biological mechanisms remain speculative, but such an unexpected relation with prognosis and absence of correlation between HIF-1alpha and CAIX suggests that the prognostic association of HIF-1alpha may not directly be linked with hypoxia. Accordingly, the role of HIF-1alpha might be more complex than previously thought and the use of this marker as a hypoxia-related prognostic factor should be addressed with caution.

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