Abstract. The transcription factor TWIST is an important factor in regulating epithelial-mesenchymal transition (EMT) and tumor metastasis. To explore the functions of TWIST in hypopharyngeal cancer, we investigated if overexpression of TWIST has an effect on FaDu cell morphology, and if alteration of TWIST has an effect on E-cadherin, N-cadherin, c-fos, MMP-9, as well as in cell migration, and the invasion ability of FaDu cells. Moreover, we also studied the relationship between TWIST overexpression and clinicopathological characteristics in hypopharyngeal cancer tissue samples by immunohistochemical assays. The results showed that overexpression of TWIST-induced morphological changes, such as occurrence of EMT. TWIST overexpression also increased cell migration and invasion ability, accompanied by an alteration of E-cadherin, N-cadherin, c-fos and MMP-9 expression. Furthermore, immunohistochemical assays showed that TWIST overexpression was related with tumor differentiation (P=0.038), tumor size (P=0.048) and lymph node metastasis (P=0.044). The data presented reveal that overexpression of TWIST plays a significant role in the metastasis of hypopharyngeal tumors, and alteration of TWIST has an effect on the EMT, c-fos and MMP-9 expression in FaDu cells. We conclude that TWIST promotes hypopharyngeal carcinoma metastasis, and the TWIST/c-fos/MMP-9 signaling pathway may play an important role in the metastasis of FaDu cells.
IntroductionHypopharyngeal cancer is one of the most common head and neck malignancies. More than 75% of patients with hypopharyngeal cancer are at an advanced stage at the time of diagnosis (1). Lymph node metastasis is present in 60-80% of patients and it directly affects the prognosis of the disease (2). Although the locoregional control of this cancer has been significantly improved in the last decades because of the advent of new surgical techniques and approaches, this improvement does not significantly influence the overall survival rate, partly because of metastasis (3). Therefore, understanding the potential mechanism of hypopharyngeal cancer metastasis and investigating the related targeted factors of metastasis are of primary concern.Recently, some studies have shown that TWIST, a basic helix-loop-helix (bHLH) transcription factor, is known to be essential for proper gastrulation, mesoderm formation, and neural crest migration (4). Interestingly, TWIST is required for epithelial-mesenchymal transition (EMT) (5). In addition, elevated TWIST expression was further related with tumor invasion and metastasis in esophageal squamous cell carcinomas (6). The role of TWIST in promoting EMT processes has also been reported in other solid cancers, such as prostate and uterine cancer (7,8). EMT and its accompanying reduction in E-cad expression have been shown to be essential for the extravasation of cancer cells into secondary organs (9). Previous research has confirmed that TWIST overexpression not only promotes the migration and invasion of cancers cells, but also decreases the sensitivi...