title: Twist-1 up-regulation in carcinoma correlates to poor survival.
abstract: Epithelial-to-mesenchymal transition (EMT) facilitates tumor metastasis. Twist is a basic helix-loop-helix protein that modulates many target genes through E-box-responsive elements. There are two twist-like proteins, Twist-1 and Twist-2, sharing high structural homology in mammals. Twist-1 was found to be a key factor in the promotion of metastasis of cancer cells, and is known to induce EMT. Twist-1 participation in carcinoma progression and metastasis has been reported in a variety of tumors. However, controversy exists concerning the correlation between Twist-1 and prognostic value with respect to carcinoma. A systematic review and meta-analysis were performed to determine whether the expression of Twist-1 was associated with the prognosis of carcinoma patients. This analysis included 17 studies: four studies evaluated lung cancer, three evaluated head and neck cancer, two evaluated breast cancer, two evaluated esophageal cancer, two evaluated liver cancer and one each evaluated osteosarcoma, bladder, cervical and ovarian cancer. A total of 2006 patients were enrolled in these studies, and the median trial sample size was 118 patients. Twist-1 expression was associated with worse overall survival (OS) at both 3 years (hazard ratio "HR" for death = 2.13, 95% CI = 1.86 to 2.45, p < 0.001) and 5 years (HR for death = 2.01, 95% CI = 1.76 to 2.29, p < 0.001). Expression of Twist-1 is associated with worse survival in carcinoma.
authors.affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, No. 270 Dong An Road, Shanghai 200032, China. 13671717421@163.com.
authors.forename: Alimujiang
authors.initials: A
authors.lastname: Wushou
authors.affiliation: Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong An Road, Shanghai 200032, China. 13671717421@163.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Hou
authors.affiliation: Department Oral & Maxillofacial Surgery, College and Hospital of Stomatology, Xi'an Jiao Tong University, No. 98 Xiwu Road, Xi'an 710004, China. zhaoyajun_1@126.com.
authors.forename: Ya-Jun
authors.initials: YJ
authors.lastname: Zhao
authors.affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, No. 270 Dong An Road, Shanghai 200032, China. zhiminshao@yahoo.com.
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Shao
mesh_terms: D015972:Gene Expression Regulation, Neoplastic; D018740:Genetic Heterogeneity; D006801:Humans; D009369:Neoplasms / Q000235:genetics*; D009687:Nuclear Proteins / Q000235:genetics* / Q000378:metabolism; D011379:Prognosis; D017594:Publication Bias; D016019:Survival Analysis; D051879:Twist-Related Protein 1 / Q000235:genetics* / Q000378:metabolism; D015854:Up-Regulation / Q000235:genetics*
chemical_list: D009687:Nuclear Proteins; C103173:TWIST1 protein, human; D051879:Twist-Related Protein 1