title: Twist and snai1 expression in pharyngeal squamous cell carcinoma stroma is related to cancer progression.
abstract: BACKGROUND
  Epithelial-mesenchymal transition (EMT) is a crucial process in tumorigenesis since tumor cells attain fibroblast-like features enabling them to invade to surrounding tissue. Two transcription factors, TWIST and SNAI1, are fundamental in regulating EMT.
  
  
  METHODS
  Immunohistochemistry was used to study the expression of TWIST and SNAI1 in 109 pharyngeal squamous cell carcinomas.
  
  
  RESULTS
  Tumors with intense stromal staining of TWIST relapsed more frequently (p = 0.04). Tumors with both positive TWIST and SNAI1 immunoreactivity in the stroma were at least Stage II (p = 0.05) and located more often in hypopharynx (p = 0.035). Tumors with negative immunostaining of TWIST and SNAI1 in the stromal compartment were smaller (T1-2) (p = 0.008), less advanced (SI-II) (p = 0.031) and located more often in the oropharynx (p = 0.007). Patients with negative SNAI1 and TWIST immunostaining in tumor stroma had a better 5-year disease-specific and overall survival (p = 0.037 and p = 0.014 respectively).
  
  
  CONCLUSIONS
  TWIST and SNAI1 expression in stromal cells is associated with clinical and histopathological characteristics that indicate progressive disease. Negative expression of these EMT-promoting transcription factors predicts a better outcome.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital, FI-70211 Kuopio, Finland. anna.jouppila-matto@kuh.fi
authors.forename: Anna
authors.initials: A
authors.lastname: Jouppila-Mättö
authors.forename: Mervi
authors.initials: M
authors.lastname: Närkiö-Mäkelä
authors.forename: Ylermi
authors.initials: Y
authors.lastname: Soini
authors.forename: Matti
authors.initials: M
authors.lastname: Pukkila
authors.forename: Reijo
authors.initials: R
authors.lastname: Sironen
authors.forename: Hanna
authors.initials: H
authors.lastname: Tuhkanen
authors.forename: Arto
authors.initials: A
authors.lastname: Mannermaa
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Kosma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D016009:Chi-Square Distribution; D018450:Disease Progression; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D005387:Finland; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000096:biosynthesis* / Q000737:chemistry; D010610:Pharyngeal Neoplasms / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D000071250:Snail Family Transcription Factors; D017154:Stromal Cells / Q000378:metabolism* / Q000473:pathology; D014157:Transcription Factors / Q000096:biosynthesis* / Q000737:chemistry; D051879:Twist-Related Protein 1 / Q000096:biosynthesis* / Q000737:chemistry
chemical_list: D009687:Nuclear Proteins; C000604407:SNAI1 protein, human; D000071250:Snail Family Transcription Factors; C103173:TWIST1 protein, human; D014157:Transcription Factors; D051879:Twist-Related Protein 1