HIF-1α overexpression is a poor prognostic indicator for patients with GC and is highly correlated with histology, depth of invasion, and microvessel density.286 HIF-1α stimulates multidrug resistance in GC cells through stimulating the transcription of miR-27a.287 HIF-1α-induced miRNA-421 promotes metastasis, inhibits apoptosis, and induces cisplatin resistance by targeting E-cadherin and caspase-3 in GC.288 Liu et al. suggested that HIF-1α and Wnt/β-catenin signaling pathways promote the invasion of hypoxic GC cells.48 This evidence concerns the gene HIF1A and gastric cancer.