Correlation of Increased Twist With Lymph Node Metastasis in Patients With Oral Squamous Cell Carcinoma

Abstract

To investigate the protein expression of Twist, Snail, and Slug in oral squamous cell carcinoma (OSCC) samples and evaluate the potential correlation between the expression status and clinicopathologic features in patients with OSCC. Twist, Snail, and Slug protein expression was assessed by immunohistochemistry in a total of 60 OSCC samples and 10 normal oral mucosal samples. The associations between the protein expression and clinicopathologic parameters were mainly detected using the χ(2) test. The survival analysis was performed using the Kaplan-Meier method, and the prognostic analysis was performed using Cox regression models. Immunohistochemistry stain analysis showed that positive Twist, Snail, and Slug protein expression was observed in 70%, 63.3%, and 58.3% of the cases, respectively. Twist protein expression was positively associated with lymph node metastasis, pathologic grade, and tumor stage (P = .012, P = .008, and P = .004, respectively, χ(2) test). All patients were followed up for 6 to 59 months (mean 37). A correlation between Twist protein expression and tumor recurrence was detected (log-rank test, P = .025). Nevertheless, no correlation was found between the Snail and Slug protein expression and the clinicopathologic parameters. Twist might serve as a useful molecular marker for lymph node metastasis and a poor prognosis in OSCC.