The Role of TWIST in Ovarian Epithelial Cancers

• Published in: Journal of pathology and translational medicine Vol. 48; no. 4; pp. 283 - 291
• Main Authors: Kim, Kyungbin, Park, Eun Young, Yoon, Man Soo, Suh, Dong Soo, Kim, Ki Hyung, Lee, Jeong Hee, Shin, Dong Hoon, Kim, Jee Yeon, Sol, Mee Young, Choi, Kyung Un
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Pathologists, Korean Society for Cytopathology 01.08.2014; The Korean Society of Pathologists and The Korean Society for Cytopathology; 대한병리학회
• Subjects: Breast cancer; Medical research; Original; Ovarian cancer; Studies; 병리학; Cadherins; TWIST transcription factor; Ovarian epithelial cancer; HIF1α; Tumor suppressor protein p53
• ISSN: 1738-1843; 2383-7837; 2092-8920; 2383-7845
• DOI: 10.4132/KoreanJPathol.2014.48.4.283

Epithelial-mesenchymal transition (EMT) is associated with tumor hypoxia. EMT is regulated, in part, by the action of TWIST, which inhibits of E-cadherin expression and may interfere with the p53 tumor-suppressor pathway. We examined the expression of TWIST, E-cadherin, hypoxia-inducible factor 1α (HIF1α), and p53 by immunohistochemistry in 123 cases of ovarian epithelial cancers (OEC) to evaluate the role of TWIST in OEC. We assessed the association between protein expression and clinicopathologic parameters. The expression of TWIST, E-cadherin, HIF1α, and p53 proteins was found in 28.5%, 51.2%, 35.0%, and 29.3% of cases, respectively. TWIST expression was associated with higher histologic grade and unfavorable survival. TWIST expression was correlated with HIF1α expression and reduced E-cadherin expression. The altered HIF1α/TWIST/E-cadherin pathway was associated with lower overall survival (OS), while the co-expression of TWIST and p53 was correlated with lower progression-free survival. In the multivariate analyses, TWIST expression was an independent prognostic factor for OS. Our data imply that TWIST expression could be a useful predictor of unfavorable prognosis for OEC. TWIST may affect the p53 tumor-suppressor pathway. Moreover, hypoxia-mediated EMT, which involves the HIF1α/TWIST/E-cadherin pathway may play an important role in the progression of OEC.