Immunohistochemical Expression of Hypoxia-Inducible Factor-1 Alpha in Oral Squamous Cell Carcinoma

Oral squamous cell carcinoma (OSCC), a malignant neoplasm of the oral cavity, is commonly observed in the northeastern region of India, likely due to dietary habits, the prevalence of infections, and possibly genetic predisposition. Hypoxia plays a crucial role in regulating tumor proliferation and survival. In the absence of sufficient oxygen, several mechanisms and factors become instrumental in driving tumorigenesis. One such factor is hypoxia-inducible factor-1 alpha (HIF-1α), a key transcription factor from the inducible factor family that regulates gene expression in response to reduced cellular oxygen levels. Despite its significance, studies investigating HIF-1α overexpression in OSCC remain limited, and only a few have explored its correlation with clinical and pathological parameters. This study involved a retrospective analysis of histopathologically confirmed OSCC cases from resected oral specimens collected over a four-year period (2020-2024). HIF-1α overexpression was evaluated in relation to clinical variables such as age and sex and pathological features including histological grade, stage, depth of invasion (DOI), tumor size, lymphovascular invasion, perineural invasion, and worst pattern of invasion. A statistically significant association was observed between HIF-1α overexpression and both higher tumor stage and greater DOI, supporting its link to more aggressive disease behavior. Given the complexity of OSCC, identifying markers that may serve as therapeutic targets is of critical importance. HIF-1α emerges as one such marker - its presence not only indicates a more aggressive tumor phenotype but also suggests potential for future targeted therapies.