Relationship between serum hypoxia inducible factor-1α and lactate dehydrogenase expression and postoperative recurrence of middle and advanced ovarian cancer

HAO Cuipei; ZHANG Lu; LIU Yiping; LI Bin

doi:10.3969/j.issn.1009-0460.2025.01.006

Abstract：Objective To investigate the relationship between serum hypoxia inducible factor-1α(HIF-1α)and lactate dehydrogenase(LDH)expression and postoperative recurrence of middle and advanced ovarian cancer.Methods The clinical data of 130 patients with advanced ovarian cancer who received tumor cell reduction from January 2018 to December 2023 were retrospectively collected as case group.In the same period,the clinical data of 130 healthy people were included as the control group according to 1∶1 ratio.According to postoperative recurrence,the patients were divided into recurrence group and non-recurrence group.Serum HIF-1α,LDH and baseline data of patients in case group,control group,recurrence group and non-recurrence group were compared.Univariate Logistic regression model was used to examine the effects of serum HIF-1α and LDH on postoperative recurrence.Receiver operating characteristic(ROC)curve was plotted at the same time,and the area under the curve(AUC)was used to evaluate the predictive value of serum HIF-1α and LDH for postoperative recurrence in patients with advanced ovarian cancer.A decision curve was drawn to evaluate the clinical net benefit of the model.Results The serum levels of HIF-1α and LDH in the case group were(654.46±34.45)pg/ml and(220.92±23.35)U/L,respectively,which were higher than(420.62±36.62)pg/ml and(140.62±22.51)U/L in the control group(P<0.05).The follow-up results showed that 45 out of 130 patients with advanced ovarian cancer experienced recurrence after tumor cell reduction surgery,with a recurrence rate of 34.6%(45/130).The number of PARP-1 positive expression rates,HIF-1α,LDH,HE4,and CA125 levels in the recurrence group were significantly higher than those in the non-recurrence group(P<0.05).The Logistic regression model showed that serum HIF-1α,LDH,and HE4 were independent factors affecting postoperative recurrence(P<0.05).The ROC curve showed that serum HIF-1α and LDH had moderate predictive value for recurrence,with AUC values of 0.856 and 0.874,respectively;The combined predictive value of the two was the highest,with AUC value of 0.938(P<0.05).The decision curve showed that within the threshold range of 0.27-0.48 and 0.79-1.00,the net return rate of serum HIF-1α and LDH combined prediction for postoperative recurrence was significantly better than that of a single indicator,and within the high-risk threshold range of 0.00-1.00,the net return rate of the two combined predictions was greater than 0.Pearson correlation analysis showed a positive correlation between serum HIF-1α and LDH(r=0.374,P<0.001).Conclusion Serum HIF-1α and LDH are elevated in patients with middle and advanced ovarian cancer,and they have good predictive value for postoperative recurrence.