Significance of Twist expression and its association with E-cadherin in esophageal squamous cell carcinoma

Abstract

BackgroundTwist is a basic helix-loop-helix (bHLH) transcriptional factor that has been identified to play an important role in epithelial-mesenchymal transition (EMT)-mediated metastasis through the regulation of E-cadherin expression. However, few authors have examined the expression of Twist and E-cadherin and their prognostic value in patients with esophageal squamous cell carcinoma (ESCC). The purpose of this study is to evaluate the clinical significance of Twist and E-cadherin expression in ESCC.MethodsWe immunohistochemically investigated the relationship between their expression and clinicopathological factors including prognosis in surgical specimens of primary tumors in 166 patients with ESCC.ResultsThe expression rate of high Twist was 42.0% and that of preserved E-cadherin was 40.4%. The expression of high Twist and reduced E-cadherin was significantly associated with depth of tumor invasion, lymph node metastasis, distant nodal metastasis, stage and lymphatic invasion, and poor prognosis. High Twist expression significantly correlated with reduced E-cadherin expression. In the preserved E-cadherin group, the 5-year survival rate was better for patients who were low for Twist expression than for those who were high for Twist expression. Multivariate analysis indicated that the combination of low Twist and preserved E-cadherin expression was an independent prognostic factor along with tumor depth, distant nodal metastasis and E-cadherin expression.ConclusionsEvaluation of Twist and E-cadherin expressions should be useful for determining tumor properties, including prognosis, in patients with ESCC.

Maximum standardized uptake value in 18F-fluoro-2-deoxyglucose positron emission tomography is associated with advanced tumor factors in esophageal cancer

“…Low E-cadherin expression was significantly associated with a high SUVmax in the present study. Previously, it was reported that reduced E-cadherin expression is associated with tumor invasion, metastasis and a poor prognosis for patients with ESCC (24,25). Our results are comparable with those findings.…”

“…Growth factors, cytokines, extracellular matrix components and transcription factors are involved in EMT induction in epithelial tumor cells (21,22). Results of recent studies (24)(25)(26)(27)(28)(29) suggest that EMT is associated with tumor invasion, metastasis and prognosis in ESCC. However, an association between SUVmax derived from FDG-PET/CT and EMT markers in ESCC remains to be determined.…”

Classification of epithelial–mesenchymal transition phenotypes in esophageal squamous cell carcinoma is strongly associated with patient prognosis

“…Loss of E-cadherin expression is a well-documented condition for invasiveness; [14][15][16][17][18][19][20] however, this result is debatable. 3,4 Our work demonstrated that the loss of E-cadherin itself, without a mesenchymal phenotype, may not be associated with invasive behavior, whereas tumors with a mesenchymal phenotype, regardless of E-cadherin expression, showed aggressive behavior in esophageal squamous cell carcinoma.…”

Tumor initiation and progression in hepatocellular carcinoma: risk factors, classification, and therapeutic targets

“…This TGF-beta is one of the factors that can induce an Epithelial-to-Mesenchymal Transition (EMT) [80] . For different types of tumors it has been demonstrated that an EMT-switch is associated with a worse prognosis as seen in esophageal squamous cell carcinoom [81] , gastric cancer cells [82] bladder cancer [83] non-small cell lung cancer [84] and pancreas ductal adenomacarcinoma [85] . For HCC, this correlation has also been found with an independent effect of Twist and Snail in promoting metastasis of hepatocellular carcinoma [86][87][88][89] .…”