In addition, high HIF-1α protein expression was significantly associated with endometrial cancer grade, lymph node metastasis, and myometrial invasion (grade in Caucasians: OR = 3.09, 95% CI = 1.63-5.85, <i>P</i> < 0.05; lymph node metastasis: OR = 3.09, 95% CI = 1.63-5.85, <i>P</i> < 0.05; myometrial invasion: OR = 2.26, 95% CI = 2.15-5.08, <i>P</i> < 0.05).<h4>Conclusions</h4>HIF-1α overexpression was significantly associated with increased risk, advanced clinical progression, and poor prognosis in endometrial cancer patients. Here, HIF1A is linked to metastatic malignant neoplasm in the lymph nodes.