Hypoxia-inducible factor-1 alpha expression in endometriosis: A retrospective observational case–control study of ovarian cyst capsules and endometrial tissue samples

BackgroundThis study aimed to compare the expression patterns of hypoxia-inducible factor-1α in ovarian cyst capsules and endometrial tissue samples from patients with and without endometriosis to evaluate its potential as a biomarker of hypoxia in endometriosis.MethodsThis retrospective observational case-control study included 87 women of childbearing age (20-45 years) who underwent ovarian cystectomy at Balıkesir University Hospital between 2015 and 2020. Of these, 40 patients with confirmed endometriosis constituted the study group, while 47 patients with benign ovarian cysts comprised the control group. Immunohistochemical staining was used to assess the expression of hypoxia-inducible factor-1-alpha in ovarian cyst capsules and endometrial tissue samples. The relationship between the expression of hypoxia-inducible factor-1-alpha and clinical parameters, including age, body mass index, and endometriosis stage, was also evaluated.ResultsThe expression of hypoxia-inducible factor-1-alpha was significantly higher in ovarian cyst capsules and endometrial tissues of patients with endometriosis than in those of controls (p < 0.05). No correlation was found between hypoxia-inducible factor-1-alpha expression and age, body mass index, or disease stage.ConclusionsIn this study, the expression of hypoxia-inducible factor-1-alpha in the ovarian and endometrial tissues was significantly elevated in patients with endometriosis compared with that in controls, independent of clinical parameters. These results support hypoxia-inducible factor-1-alpha as a stable biomarker of hypoxia in endometriosis and provide a basis for future research on hypoxia-targeted therapies for endometriosis management.