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Hypoxia inducible factor 1α gene (HIF-1α) splice variants: potential prognostic biomarkers in breast cancer

Jean-Philippe Dales12*, Nathalie Beaufils3, Monique Silvy4, Christophe Picard4, Vanessa Pauly5, Vincent Pradel5, Christine Formisano-Tréziny1, Pascal Bonnier6, Sophie Giusiano2, Colette Charpin2 and Jean Gabert13

  • * Corresponding author: Jean-Philippe Dales

  • † Equal contributors

Author Affiliations

1 Plateforme Transcriptome, CRO2, Marseille, France

2 Department of Pathology, Hôpital Nord, Marseille, France

3 Biochemistry and Molecular Biology, Hôpital Nord, Marseille, France

4 Etablissement Français du Sang Alpes Méditerranée, Marseille, France

5 Department of Medical Information, Hôpital Sainte Marguerite, Marseille, France

6 Department of Gynaecologic Oncology, Hôpital de la Conception, Assistance-Publique Hôpitaux de Marseille, Université de la Méditerranée, Marseille, France

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BMC Medicine 2010, 8:44  doi:10.1186/1741-7015-8-44

Published: 12 July 2010



Hypoxia-inducible factor 1 (HIF-1) is a master transcriptional regulator of genes regulating oxygen homeostasis. The HIF-1 protein is composed of two HIF-1α and HIF-1β/aryl hydrocarbon receptor nuclear translocator (ARNT) subunits. The prognostic relevance of HIF-1α protein overexpression has been shown in breast cancer. The impact of HIF-1α alternative splice variant expression on breast cancer prognosis in terms of metastasis risk is not well known.


Using real-time quantitative reverse transcription PCR assays, we measured mRNA concentrations of total HIF-1α and 4 variants in breast tissue specimens in a series of 29 normal tissues or benign lesions (normal/benign) and 53 primary carcinomas. In breast cancers HIF-1α splice variant levels were compared to clinicopathological parameters including tumour microvessel density and metastasis-free survival.


HIF-1α isoforms containing a three base pairs TAG insertion between exon 1 and exon 2 (designated HIF-1αTAG) and HIF-1α736 mRNAs were found expressed at higher levels in oestrogen receptor (OR)-negative carcinomas compared to normal/benign tissues (P = 0.009 and P = 0.004 respectively). In breast carcinoma specimens, lymph node status was significantly associated with HIF-1αTAG mRNA levels (P = 0.037). Significant statistical association was found between tumour grade and HIF-1αTAG (P = 0.048), and total HIF-1α (P = 0.048) mRNA levels. HIF-1αTAG mRNA levels were also inversely correlated with both oestrogen and progesterone receptor status (P = 0.005 and P = 0.033 respectively). Univariate analysis showed that high HIF-1αTAG mRNA levels correlated with shortened metastasis free survival (P = 0.01).


Our results show for the first time that mRNA expression of a HIF-1αTAG splice variant reflects a stage of breast cancer progression and is associated with a worse prognosis.

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