Is overexpression of TWIST, a transcriptional factor, a prognostic biomarker of head and neck carcinoma? Evidence from fifteen studies.

Xianlu Zhuo,Dairong Li,Qi Zhou,Houyu Zhao,Aoshuang Chang,Huanli Luo

doi:10.1038/srep18073

Xianlu Zhuo, Dairong Li + Show 4 more

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https://doi.org/10.1038/srep18073

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Abstract

TWIST, a basic helix-loop-helix transcription factor, has been indicated to play a critical role in the progression of numerous malignant disorders. Published data on the significance of TWIST expression in head and neck carcinoma (HNC) risk have yielded conflicting results. Thus, we conducted a quantitative meta-analysis to obtain a precise estimate of this subject. After systematic searching and screening, a total of fifteen studies using immunohistochemistry for TWIST detection were included. The results showed that TWIST positive expression rate in HNC tissues was higher than that in normal tissues. TWIST expression might have a correlation with clinical features such as low differentiation, advanced clinical stage, presence of lymph node metastasis, distant metastasis and local recurrence (P < 0.05) , but not with age, gender, T stage and smoking as well as drinking (P > 0.05). In addition, over-expression of TWIST was a prognostic factor for HNC (HR = 1.92, 95% CI = 1.13–3.25). The data suggested that TWIST might play critical roles in cancer progression and act as a prognostic factor for HNC patients.

Highlights

TWIST, a basic helix-loop-helix transcription factor, has been indicated to play a critical role in the progression of numerous malignant disorders
In the present meta-analysis, the pooled results from fifteen primary studies showed that TWIST expression might have an association with low differentiation, advanced clinical stage, presence of lymph node metastasis, distant metastasis and local recurrence, indicating that TWIST expression might play an important role in the development of Head and neck carcinoma (HNC)
TWIST might act as a prognostic factor for HNC

Summary

Introduction

TWIST, a basic helix-loop-helix transcription factor, has been indicated to play a critical role in the progression of numerous malignant disorders. Published data on the significance of TWIST expression in head and neck carcinoma (HNC) risk have yielded conflicting results. Over-expression of TWIST was a prognostic factor for HNC (HR = 1.92, 95% CI = 1.13–3.25). The data suggested that TWIST might play critical roles in cancer progression and act as a prognostic factor for HNC patients. Evidence shows that several transcriptional factors might act as inducers of EMT and play critical roles in its process. A basic helix-loop-helix (BHLH) transcription factor, TWIST, is one of the important EMT inducers. Since a single study was underpowered in demonstrating the roles of TWIST in HNC progression, we aimed to conduct a quantitative meta-analysis containing published data up www.nature.com/scientificreports/

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