Metastasis is considered the most serious and fatal outcome of patients with non-small cell lung cancer (NSCLC). Twist-1 and Cripto-1 expression and their roles in induction of cancer metastases have been extensively studied as factors that are responsible for induction of the epithelial-mesenchymal transition and carcinoma metastasis, yet little information is known about expression of these proteins in NSCLC tissues and their prognostic roles in patients with such cancer.
The aim of this work is to detect the pathological, prognostic, and clinical relevance of tissue Twist-1 and Cripto-1 expressions in NSCLC and relations of their expression to patients’ outcome and response to therapy.
Patients and methods
We have examined the expressions of Twist-1 and Cripto-1 in 50 paraffin blocks, which were retrieved from 50 patients with NSCLC using immunohistochemistry. We analyzed the relationship between their level of expressions and NSCLC patient’s prognosis.
Twist-1 and Cripto-1 expressions were associated with larger tumor size (P=0.006, 0.043), advanced grade (P=0.005, 0.003), and stage (P<0.001, P=0.004), presence of malignant effusion (P=0.008), presence of distant metastases (P=0.009, P<0.001), poor response to treatment (P<0.001), poor 3-year survival rates (P<0.001), and disease progression (P<0.001). Both markers’ expression was positively correlated with each other (P=0.004).
Overexpression of both Twist-1 and Cripto-1 is considered as a useful predictive and prognostic factor for patients with NSCLC.