Prognostic and clinicopathological value of Twist expression in esophageal cancer: A meta-analysis

doi:10.4251/wjgo.v14.i9.1874

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World Journal of Gastrointestinal Oncology

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Meta-Analysis

World J Gastrointest Oncol. Sep 15, 2022; 14(9): 1874-1886
Published online Sep 15, 2022. doi: 10.4251/wjgo.v14.i9.1874

Prognostic and clinicopathological value of Twist expression in esophageal cancer: A meta-analysis

Wen-Peng Song, Su-Yan Wang, Si-Cheng Zhou, Dong-Sheng Wu, Jia-Yu Xie, Tong-Tong Liu, Xiu-Zhu Wu, Guo-Wei Che

Wen-Peng Song, Guo-Wei Che, Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China

Su-Yan Wang, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China

Si-Cheng Zhou, Dong-Sheng Wu, Xiu-Zhu Wu, West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China

Jia-Yu Xie, Laboratory Experiments in Microbiology, Shuang Liu Center for Disease Control and Prevention, Chengdu 610041, Sichuan Province, China

Tong-Tong Liu, West China School of Public Health & West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China

Author contributions: Song WP, Wang SY, Zhou SC and Che GW designed the research; Song WP, Zhou SC, Wu DS, Wu XZ and Xie JY conducted the literature search; Song WP and Wang SY collected and retrieved the data; Song WP, Wang SY, Wu DS, Wu XZ, Liu TT and Xie JY analyzed the data; Song WP wrote and revised the manuscript; Liu TT and Che GW contributed to editing; All authors approved the final version.

Conflict-of-interest statement: No conflicts of interest.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Guo-Wei Che, MD, PhD, Chief Doctor, Surgeon, Lung Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. cheguoweixw@126.com

Received: March 16, 2022
Peer-review started: March 16, 2022
First decision: June 12, 2022
Revised: June 30, 2022
Accepted: July 31, 2022
Article in press: July 31, 2022
Published online: September 15, 2022
Processing time: 176 Days and 21.1 Hours

ARTICLE HIGHLIGHTS

Research background

Twist can induce epithelial–mesenchymal transition (EMT) and cancer metastasis. However, the prognostic value of Twist expression in patients with esophageal cancer remains controversial.

Research motivation

To clarify whether Twist could be a promising biomarker for predicting prognosis in esophageal cancer.

Research objectives

To investigate the prognostic and clinicopathological value of Twist expression in esophageal cancer.

Research methods

Published literature in several databases was searched for eligible articles. Participants with esophageal cancer whose tumor tissues underwent immunohistochemistry to detect the expression of Twist were considered when they met the inclusion criteria. The hazard ratio (HR) and relative ratio (RR) with their 95%CI were pooled. Heterogeneity was estimated by I²statistics.

Research results

The pooled HR for overall survival was 1.88 (95%CI: 1.32-2.69, I²= 68.6%), and the pooled HR for disease-free survival/relapse-free survival/progression-free survival was 1.84 (95%CI: 1.12-3.02, I²= 67.1%). In addition, overexpression of Twist was correlated with T stage (T3 + T4 vs T1 + T2, RR = 1.38, 95%CI: 1.14-1.67), lymph node metastasis (yes vs no, RR = 1.34, 95%CI: 1.11-1.60), distant metastasis (yes vs no, RR = 1.18, 95%CI: 1.02-1.35), tumor, node and metastasis (TNM) stage (III + IV vs I + II, RR = 1.35, 95%CI: 1.14-1.60), and clinical stage (III + IV vs I + II, RR = 1.58, 95%CI: 1.34-1.87).

Research conclusions

Twist overexpression indicates poor esophageal cancer prognosis. Moreover, Twist overexpression is correlated with T stage, lymph node metastasis, distant metastasis, TNM stage, and clinical stage, which indicates that Twist might accelerate esophageal cancer progression and metastasis.

Research perspectives

Our meta-analysis suggests that Twist might be a valuable prognostic biomarker in esophageal cancer.