Hypoxia can upregulate the expression of hypoxia inducible factors (HIF), nucleolar and spindle-associated protein 1 (NUSAP1), and NADH dehydrogenase (ubiquinone) 1 alpha subcomplex 4-like 2 (NDUFA4L2), promoting of osteosarcoma cells survival, epithelial-mesenchymal transition, invasion and migration, [13,14]. This evidence concerns the gene COXFA4L2 and osteosarcoma.