Abstract: Expression of Twist, ARF and E-cadherin and Its Clinical Significance in Colorectal CancerJuan ZHANG, JunWEI, ShijieWANG, Yueming YU, Shan YANG, GuiyingWANGCorrespondence to: GuiyingWANG, E-mail: tizq12@vip.163.comThe Second Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaAbstract Objective: To study the correlation of the expression of Twist, ARF and E-cadherin with the clinicopathologic parame-ters of colorectal cancer, and to analyze the relationships among Twist, ARF and E-cadherin proteins and tumorigenesis, invasion andmetastasis of colorectal cancer. Methods: Immunohistochemistry staining (SP) was conducted to detect the expression of Twist, ARFand E-cadherin protein in 60 samples of colorectal tumors and 60 samples of normal colorectal mucosa. Results: The positive rate ofTwist was significantly higher in the carcinoma samples than in the normal colorectal mucosa ( P < 0.05 ). The positive rate of ARF andE-cadherin was significantly lower in the carcinoma samples than in the normal colorectal mucosa ( P < 0.05 ). The expression of Twistwas correlated with the pathological grading of the colorectal cancer, the depth of tumor infiltration into the wall of the large intestine,the presence of lymph node metastases and TNM staging ( P < 0.05). The expression of ARF and E-cadherin was correlated with patho-logical grade of the cancer, depth of tumor infiltration, the presence of lymph node metastases, TNM stage and the presence of distantmetastasis ( P < 0.05 ). There were 10 cases with equally positive expression of Twist and ARF in the colorectal carcinoma group and 8with equally negative expression. There was a significant negative correlation between Twist and ARF expression in the carcinoma sam-ples ( r = 0.806, P = 0.004 < 0.05 ). There were 3 colorectal carcinoma cases with simultaneous positive expression of Twist and E-cad-herin and 7 with simultaneous negative expression. There was a remarkable negative correlation between Twist and E-cadherin expres-sion in colorectal carcinoma ( r = 0.754, P = 0.006 < 0.05). Conclusion: The overexpression of Twist and underexpression of ARF andE-cadherin may play an important role in the tumorigenesis, invasion and metastasis of colorectal cancer. Twist can inhibit apoptosisand promote tumor cell formation by regulating the ARF/MDM2/P53 pathway. Twist can also simultaneously affect the expression ofE-cadherin and promote epithelial mesenchymal transition (EMT), thus participating in the genesis and metastasis of colorectal cancer.Keywords Colorectal cancer; Twist; ARF; E-cadherin; Immunohistochemistry