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Research Article

JCR. 2020; 7(10): 6291-6302


IMMUNOHISTOCHEMICAL STUDY OF TWIST1 IN INVASIVE DUCT CARCINOMA OF THE BREAST

Azza M. Abelzaher, Manal Esmail Abdelghany, Nehad M. Reda Abdel maqsoud, Heba M. Tawfiq, Wafaa farghaly Aref.

Abstract
Twist1 is a key transcription factor, which confers tumor cells with cancer stem cell (CSC)-like characteristics and
enhances epithelial–mesenchymal transition (EMT) in pathological conditions including tumor malignancy and
metastasis. This study aimed to evaluate the expression patterns and clinical significance of Twist1 in invasive duct
carcinoma of the breast. The cytoplasmic and nuclear expressions of Twist1 were examined in 70 tumor tissues by
immunohistochemistry. The association between expression patterns of this marker and clinicopathologic parameters
was analyzed separately. Twist1 was localized to the cytoplasm of tumor cells in (21.4%) of cases. It was localized to
the nucleus of tumor cells in (48.6%) of cases. Increased cytoplasmic expression of Twist1 was associated with smaller
tumor size (P = 0.011). Nuclear Twist1 was positively correlated with higher grade tumors (P = 0.002), lymph node
status (>3 lymph nodes) (P = 0.049), poor Nottingham prognostic index (p=0.043), ER and PR negativity (p=0.048 and
0.016 respectively), Molecular subtypes (p=0.038) and distant metastasis (p=0.001). Increased nuclear expression of
Twist1 had a critical role in worse prognosis in breast cancer. These findings suggest that nuclear, rather than
cytoplasmic expression of Twist1 can be considered as a prognostic and therapeutic marker for targeted therapy of
breast cancer patients.

Key words: Twist1 · Epithelial–mesenchymal transition (EMT)



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