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The expression of Twist has an impact on survival in human bladder cancer and is influenced by the smoking status
Urologic Oncology: Seminars and Original Investigations, 07/01/09
Fondrevelle ME et al. - In a trial to investigate the expression of Twist and those of E- and N-cadherin in human primary bladder tumor and to evaluate its prognostic value, it was found that positive Twist expression may be a useful prognostic marker for pts with bladder cancer. Its expression seems to be correlated to tobacco status of the pts.
Methods- To delineate the oncogenic role for Twist in human bladder cancer, E- and N-cadherin as well as Twist expression (n = 70) were evaluated by immunohistochemistry.
- The prognostic value of these expressions were evaluated.
- Researchers tried to correlate these protein expressions to the smoking status of the pts.
- Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard analysis.
- Of the 70 bladder tumors, 28 (40%) cases were positive for Twist expression, 16 (23%) cases were negative for E-cadherin expression, and 12 (17%) were positive for N-cadherin expression.
- When categorized into negative vs positive expression, Twist was associated with stage, grade, progression, and E-cadherin expression.
- Positive Twist expression clearly predicted poorer PFS.
- In multivariate analysis, both positive Twist expression and loss of E-cadherin expression were independent prognostic factors for PFS and only loss of E-cadherin expression for the OS.
- Almost 60% (16/28) of pts with Twist-positive expression were current smokers at the time of the diagnosis, corroborating the fact that smoking modulates expression of epithelial mesenchymal transition markers including Twist.
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