Hypoxia Inducible Factor 1 Alpha and 2 Alpha Expression is Independent of Anemia in Patients with Stage I Endometrial Cancer

Objective: To investigate whether anemia, a putative factor counteracting the efficacy of radiotherapy, up-regulates the endogenous markers of intratumoral hypoxia, the hypoxia inducible factors HIF1 alpha and HIF2 alpha.

Materials And Methods: Forty-two hysterectomy specimens harboring endometrial adenocarcinomas of the endometrioid cell type, stage I were investigated immunohistochemically for the expression of HIF1 alpha, HIF2 alpha and the down-stream inducible expression of vascular endothelial growth factor VEGF. The results were correlated with hemoglobin (Hb) levels.

Results: There was no significant association between Hb levels and the expression of HIF1 alpha, HIF2 alpha or VEGF in our material.

Conclusion: Activation of hypoxia pathways is an intrinsic self-regulated process, independent of Hb levels in endometrial adenocarcinomas. Other factors such as microvessel density (MVD), vessel/tumor cell distance or genetic events may be important.