Expression and significance of Twist protein in colorectal cancer

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Objective To explore the expression of Twist protein in the colorectal cancer (CRC) and its relationship between clinicopathological factors and prognosis of patients. Methods The clinical data of 45 patients with colorectal cancer who were admitted to the First People's Hospital of Shunde from June 2005 to September 2005 were retrospectively analyzed. The colorectal tissue specimens from surgical resection were collected. The expressions of Twist protein in the cancer and paracarcinoma tissues were examined by the immunohistochemistry, and their relationship with clinicopathological factors and prognosis of patients was analyzed. Patients were followed up by outpatient examination and telephone interview until September 2013. The count data were analyzed using the chi-square test and Fisher exact probability. The survival curve was generated using the Kaplan-Meier method, and the survival analysis was conducted using the Log-rank test. The prognosis factors were analyzed by the COX univariate analysis and multivariate analysis. Results The expression of Twist protein in CRC was predominantly detected in the cytoplasm of the tumor cells. The positive expression rates of Twist protein in the CRC and paracarcinoma tissues were 62.2% (28/ 45) and 20.0% (9/ 45) , respectively, with a significant difference (χ2 = 18.383, P <0.05) . The positive expression rates of Twist protein were 42.1% in patients with Ⅰ-Ⅱ stage of CRC and 76. 9% in patients with Ⅲ-Ⅳ stage of CRC. The positive expression rates of Twist protein were 41. 7% in patients with N0 stage of CRC and 85.7% in patients with N1 -N2 stage of CRC. The expression of Twist protein in patients with CRC was however associated with the TNM stage and lymph node metastasis (χ2=5.662, 9.244, P <0.05) . A total of 45 patients were followed up for 10- 96 months (median, 54 months) . The median survival time and 5-year cumulative survival rate in 45 patients with positive expression of Twist protein were 44 months and 10.7% ,which were compared with 69 months and 82.4% in 45 patients with negative expression of Twist protein ,with a statical significance in the survival (χ2 =26.147, P <0.05) . The results of univariate analysis showed that the expression of Twist protein was an related factor affecting the prognosis of patients [HR = 8.669, 95% confidence interval (CI) : 2.959- 25.390, P <0.05 ] . The results of multivariate analysis showed that the positive expression of Twist protein was an independent risk factor affecting the prognosis of patients (HR = 5.059, 95% CI: 2.888- 8.863, P <0.05) . Conclusions The increasing expression of Twist protein in the CRC is positively correlated with the occurrence and development of CRC. The positive expression of Twist protein is an independent risk factor affecting the prognosis of patients with CRC. Key words: Colorectal neoplasms; Twist protein; Prognosis