Prognostic Roles of Combined Twist-1&E-Cadherin Tissue Protein Expression in Clear Cell Renal Cell Carcinoma (cc-RCC); An Immunohistochemical Study

Background, clear cell renal cell carcinoma (cc-RCC), which is the commonest type of renal cell carcinoma (RCC), is spreading mainly through the blood that leads to its poorer prognosis than other histopathological RCC subtypes. It is essential to identify the molecular pathogenesis of cc-RCC initiation, progression invasion and spread aiming at detection of novel targeted therapies for improving patients& #039, outcome. Twist-1 that is considered a basic helix-loop-helix (bHLH) highly conserved transcription factor that is characterized by the presence of a basic domain which binds to DNA and such domain targets E-box sequence 59-CANNTG-39 and another helix-loop-helix domain. E-cadherin (E-cad) that is a cell adhesion factor which is normally found in the epithelial cell membrane. Aim of that work was to assess tissue protein markers Twist 1& E-cadherin expressions in both non-neoplastic and malignant tissue in cc-RCC patients, to evaluate relations between both markers in initiation of EMT in cc-RCC, and to clarify significance of their combined tissue protein expression, clinicopathological parameters of the tumor, cc-RCC progression, recurrence and patient survival. Methods, tissue protein markers Twist 1& E-cadherin combined expression using immunohistochemistry method was assessed samples from 40 patients with cc-RCC and 10 samples of adjacent non-neoplastic kidney tissue. We followed cc-RCC patients for 5 years, detected associations between the combined tissue protein markers expressions, clinicopathological parameters of the tumor, cc-RCC progression, recurrence and patient survival Results, combination of up regulation of Twist 1 and down regulation of E- cadherin was noticed in cc-RCC tissues more than adjacent non-neoplastic kidney tissue (p=0.004 and p