To evaluate the role of the epithelial–mesenchymal transition (EMT) profile, Twist, E-cadherin, and vimentin in the progression of colorectal carcinoma (CRC).
Metastases are the most common cause of death in cancer patients. EMT is one of the central mechanisms that induces invasion and metastasis of tumors. Twist induces EMT and metastasis through repression of E-cadherin-mediated cell–cell adhesion and acquisition of mesenchymal markers such as vimentin.
Patients and methods
Using the standard immunohistochemical technique, we assessed Twist, E-cadherin, and vimentin expression in 93 colorectal specimens including 10 specimens from normal colonic mucosa, eight colonic adenomas, 49 CRC, and 26 metastatic CRC and correlated our results with the available clinicopathological parameters.
All normal mucosa specimens showed low Twist expression; however, 75% of adenoma cases showed high-Twist cytoplasmic expression. All normal mucosa and adenoma specimens showed high E-cadherin and negative vimentin expression. Regarding primary CRC, 69.4% showed high-Twist cytoplasmic expression, 34.7% showed high-Twist nucleocytoplasmic expression, 93.9% showed low E-cadherin expression, and 24.5% showed positive vimentin expression. In metastatic CRC, 84.6% showed high-Twist cytoplasmic expression, 34.6% showed high-Twist nucleocytoplasmic expression, 92.3% showed low E-cadherin expression, and 30.8% showed positive vimentin expression.
Cytoplasmic Twist overexpression was negatively correlated with E-cadherin and positively correlated with vimentin in CRC and this confirms the EMT signature in CRC. Nucleocytoplasmic Twist expression was associated with poor prognostic factors in primary CRC, while cytoplasmic Twist expression was associated with poor prognostic factors in metastatic CRC.