title: Increased Twist expression in advanced stage of mycosis fungoides and Sézary syndrome.
abstract: BACKGROUND
  The mechanisms of tumor progression in mycosis fungoides (MF) and Sézary syndrome (SS) are poorly understood. Twist, a transcription factor, is thought to promote solid tumor progression by blocking p53 and inhibiting c-myc-induced apoptosis. Whether Twist expression is correlated to MF/SS stages remains unknown.
  
  
  METHODS
  Twist, c-myc and p53 proteins in 68 MF/SS lesions across all T stages were examined by immunohistochemistry, and mRNA levels in peripheral blood CD4+ T-cells from SS patients were measured by real-time quantitative polymerase chain reaction.
  
  
  RESULTS
  Positive staining for Twist was found in 12.5% (2/16) of T1 and 33.3% (7/21) of T2 early stage patches/plaques compared to 50.0% (9/18) of T3 tumors and 84.6% (11/13) of T4 erythroderma. Most T4 erythroderma were positive for Twist in dermal lymphocytes, with the strongest staining. Positive staining for c-myc was higher in T3/T4 lesions (29/31, 93.5%) than T1/T2 lesions (25/37, 67.6%, p < 0.05), with strongest staining in T3 tumors. Aberrant p53 expression was more common in T3/T4 lesions (8/31, 25.8%) than in T1/T2 lesions (2/37, 5.4%, p < 0.05). Twist mRNA was detected in all CD4+ T cells from SS patients but not in normal donors.
  
  
  CONCLUSIONS
  Increased Twist protein expression in advanced MF/SS lesions suggests that Twist expression may correlate with MF/SS stages.
authors.affiliation: Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Meghali
authors.initials: M
authors.lastname: Goswami
authors.forename: Madeleine
authors.initials: M
authors.lastname: Duvic
authors.forename: Alexis
authors.initials: A
authors.lastname: Dougherty
authors.forename: Xiao
authors.initials: X
authors.lastname: Ni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000378:metabolism / Q000473:pathology; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000096:biosynthesis*; D016271:Proto-Oncogene Proteins c-myc / Q000096:biosynthesis; D012751:Sezary Syndrome / Q000378:metabolism / Q000473:pathology; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D051879:Twist-Related Protein 1 / Q000096:biosynthesis*
chemical_list: C489427:MYC protein, human; D009687:Nuclear Proteins; D016271:Proto-Oncogene Proteins c-myc; C495901:TP53 protein, human; C103173:TWIST1 protein, human; D016159:Tumor Suppressor Protein p53; D051879:Twist-Related Protein 1