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Background : Hypoxia-inducible factor-1 (HIF-1 ) is an intrinsic marker of tumor hypoxia, and this is associated with reduced radiosensitivity. Furthermore, HIF-1 can increase a tumor''s aggressiveness by promoting neoangiogenesis, cell proliferation and survival, and invasion. Methods : The expression of HIF-1 was was investigated by performing immunohistochemistry on the cervical tissue specimens obtained from 57 patients who had received radiotherapy combined with or without chemotherapy for stages I-III cervical squamous cell carcinoma. The staining results were compared with anemia, the stage, the radiotherapy response and patient survival by univariate and multivariate analysis. Results : In 57 patients, the expression of HIF-1 was seen in the tissue specimens of 46 patients (81.7%). Among them, 25 (54.3%), 14 (30.4%), and 7 (15.2%) of the patients'' tissue specimens showed weak, moderate and strong expressions, respectively. Six patients had a partial response after radiotherapy. Twelve patients (21.1%) died of cervical cancer. The increased expression of HIF-1 was significantly associated (p<0.05) with the disease stage and anemia. There were significant positive correlations between the increased expression of HIF-1 and the poor response after radiotherapy and the patients'' survival. Conclusions : The present result suggests that the overexpression of HIF-1 in the uterine cervix could be used as a prognostic indicator for the patients treated with radiotherapy.

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