ABSTRACT
BACKGROUND: Twist2 is a transcription factor and an epithelial-to-mesenchymal transition that plays an important role in cell polarity, cell adhesion, and has a role in tumour invasion and metastases. AIM: In this study, we examined the expression of Twist2 in non-muscle invasive bladder carcinoma (NMIBC) and correlated the expression with response to treatment and tumour progression. METHODS: Data of 305 patients with NMIBC of Ta, T1 were retrieved from hospitals archives. Twist2 expression was examined in tissue samples by immunohistochemistry at initial diagnosis and final follow-up, normal control was 10 normal urothelium, 10 patients with muscle-invasive bladder cancer (MIBC) were a positive control. Treatment of NMIBC was implemented according to the European Association of Urology guidelines on NMIBC. The descriptive statistical analysis included means, standard deviation, p-value; Univariate and multivariate Cox regression analyses. RESULTS: Twist2 expression score was identified as negative, low (1-15%); medium (15-40%); and high (40-100%). Patients who had low or low medium scores at the initial diagnosis had a good response and a favourable prognosis. Expression of a high score of Twist2 in patients having high-grade T1 tumours showed non-responsiveness to repeated courses of intravesical bacillus Calmette Guerin (BCG) therapy and was upstaged to MIBC. CONCLUSION: Twist2 expression in tissue samples of NMIBC would indicate the tumour response to therapy, upgrading and upstaging in the follow up after intravesical BCG therapy.
ABSTRACT
This study evaluated the association between expression of Twist2 monogenic, with pathological features and clinical outcomes of squamous cell carcinoma of the urinary bladder (SCCUB) following radical cystectomy (RC). Immunohistochemical staining Twist2 was performed on tissue archival samples comprising normal urothelium from ten controls, cystectomy specimens from 87, patients with T2 NO MO and T3-4a NO MO of bladder squamous cell carcinoma (SCC).all patients with T2-4 SCC undergone radical cystectomy and urinary diversion, follow up was for 5-10 years to assess overall survival (OS) and disease free survival (DFS). Specimens from 10 muscle-invasive urothelial carcinoma patients were reassessed for Twist2 expression to represent over- expression of Twist2. All ten controls had normal status of biomarkers which was negative. Negative or, low, and medium expression of Twist2 was noted in SCC of the urinary bladder of local pathological status with no lymph node metastasis or distant metastasis, clinicopathologic characteristics of the cohort were pT2NO MO (n=659 and pT3-4a NO MO (n= 22). Twist2 negative expression was in 36 case, weak expression (n=33), medium expression (n=16), there were no strong expression. Twist2 low-regulation with combination of tomor stage in SCC of the urinary bladder werel independently associated with overall survival and free disease survival, 7.7 and 5 years survival in pT2 NO MO(n=65) were 89% and 13% respectively, 7.7 and 5 years survival in pT3-4a NO MO(n=22) were 72.7% and 22.7% respectively.
