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Int. J. Mol. Sci. 2014, 15(12), 21621-21630;

Twist-1 Up-Regulation in Carcinoma Correlates to Poor Survival

1,2,†, 2,3,†, 4,† and 1,2,*
Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, No. 270 Dong An Road, Shanghai 200032, China
Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong An Road, Shanghai 200032, China
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Fudan University, No. 270 Dong An Road, Shanghai 200032, China
Department Oral & Maxillofacial Surgery, College and Hospital of Stomatology, Xi'an Jiao Tong University, No. 98 Xiwu Road, Xi'an 710004, China
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 16 August 2014 / Revised: 20 October 2014 / Accepted: 11 November 2014 / Published: 25 November 2014
(This article belongs to the Special Issue Advances in Molecular Oncology 2014)
PDF [1018 KB, uploaded 25 November 2014]


Epithelial-to-mesenchymal transition (EMT) facilitates tumor metastasis. Twist is a basic helix-loop-helix protein that modulates many target genes through E-box-responsive elements. There are two twist-like proteins, Twist-1 and Twist-2, sharing high structural homology in mammals. Twist-1 was found to be a key factor in the promotion of metastasis of cancer cells, and is known to induce EMT. Twist-1 participation in carcinoma progression and metastasis has been reported in a variety of tumors. However, controversy exists concerning the correlation between Twist-1 and prognostic value with respect to carcinoma. A systematic review and meta-analysis were performed to determine whether the expression of Twist-1 was associated with the prognosis of carcinoma patients. This analysis included 17 studies: four studies evaluated lung cancer, three evaluated head and neck cancer, two evaluated breast cancer, two evaluated esophageal cancer, two evaluated liver cancer and one each evaluated osteosarcoma, bladder, cervical and ovarian cancer. A total of 2006 patients were enrolled in these studies, and the median trial sample size was 118 patients. Twist-1 expression was associated with worse overall survival (OS) at both 3 years (hazard ratio “HR” for death = 2.13, 95% CI = 1.86 to 2.45, p < 0.001) and 5 years (HR for death = 2.01, 95% CI = 1.76 to 2.29, p < 0.001). Expression of Twist-1 is associated with worse survival in carcinoma. View Full-Text
Keywords: Twist-1; immunohistochemistry; tumor; prognosis; meta-analysis Twist-1; immunohistochemistry; tumor; prognosis; meta-analysis

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Wushou, A.; Hou, J.; Zhao, Y.-J.; Shao, Z.-M. Twist-1 Up-Regulation in Carcinoma Correlates to Poor Survival. Int. J. Mol. Sci. 2014, 15, 21621-21630.

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