Expression of TWIST, an inducer of epithelial-mesenchymal transition, in nasopharyngeal carcinoma and its clinical significance.

Epithelial-mesenchymal transition (EMT) has been implicated in the development of a number of cancers. An important EMT inducer, TWIST, has been detected to be over-expressed in a variety of tumors, but rarely been studied in nasopharyngeal carcinoma (NPC). This study aimed to examine TWIST expression and its association with clinicopathological factors and prognosis in NPC. A total of 65 NPC and 20 normal samples were involved in the present study. RT-PCR and immunohistochemistry were used to examine the mRNA and protein expressions of TWIST in NPC and normal tissues. The relationship of TWIST expression levels with clinical features and prognosis of NPC patients were analyzed. The positive rate of TWIST expression was markedly higher in NPC tissues than that in normal tissues. Over-expression of TWIST was correlated with N stage and the presence of distant metastasis. Patients with positive TWIST expression had a significantly shorter overall survival time relative to patients with negative TWIST expression. The data suggest that TWIST over-expression has a correlation with lymphatic and distant metastasis in NPC. Moreover, it might be a novel biomarker for prediction of advanced tumor progression and a potential unfavorable prognostic factor as well as a potential treatment target for NPC.