A comprehensive exploration of twist1 to identify a biomarker for tumor immunity and prognosis in pan-cancer

Sep 21, 2026

Twist1 is recognized as a critical tumor gene, yet its pan-cancer significance has remained limited. This study integrates multiple databases and computational analyses to evaluate twist1 RNA expression, clinical associations, gene mutations, tumor stemness, tumor microenvironment features, and immune regulatory relationships. Fluorescence staining validates twist1 expression across tumor masses. Protein-protein interaction, enrichment analyses, predictive drug selection, and molecular docking support mechanistic interpretations. Twist1 is elevated across cancer types and links to stage, grade, and poor prognosis, associating with mutations, RNA modifications, stemness, immunoregulation, and immune checkpoints.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages14

Reading Time35 min

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Introduction

Tumor microenvironment and therapy objective

® Observational Study A comprehensive exploration of twist1 to identify a biomarker for tumor immunity and prognosis in pan-cancer Yue Wang, MDa ,b , Chunhao Li, MDb , Tianjiao Jiang, MDb , Yiqiang Yin, MDb ,c , Yaowen Wang, MDa , Hui Zhao, MDb ,d , Liang Yu, MD, PhDb ,* | Abstract
Twist1 has been identified as a critical gene in tumor, but current study of this gene remains limitative. This study aims to investigate its roles and potential mechanisms across pan-cancer. The study used various databases and computational techniques to analyze twist’s RNA expression, clinical data, gene mutations, tumor stemness, tumor microenvironment, immune regulation. Furthermore, the experimental method of fluorescence staining was carried out to identify twist1 expression in various tumor masses . After analyzing the protein-protein interaction of TWIST, enrichment analysis and predictive potential drugs were performed, and molecular docking was conducted to validate. We found that twist1 expression was significantly higher in various types of cancer and associated with tumor stage, grade, and poor prognosis in multiple cancers . Differential expression of twist1 was linked to gene mutation, RNA modifications, and tumor stemness. Additionally, twist1 expression was positively associated with tumor immunoregulation and immune checkpoint. Salinomycin, klugline, isocephaelince, manassantin B, and pimonidazole are predictive potential drugs targeting TWIST1 . This study revealed that twist1 plays an important role in tumor, and might be a curial marker in tumor diagnose and prognosis. The study also highlighted twist1 as a promising therapeutic target for cancer treatment and provided a foundation for future research. | | --- | | Abbreviations: BLCA = bladder urothelial carcinoma, BRCA = breast invasive carcinoma, CESC = cervical squamous cell carcinoma and endocervical adenocarcinoma, CHOL = cholangiocarcinoma, COAD = colon adenocarcinoma, COADREAD = colon adenocarcinoma/rectum adenocarcinoma esophageal carcinoma, DFI = disease-free survival, DNAss = DNA methylationbased stemness scores, DSS = disease-specific survival, EMT = epithelial-mesenchymal transition, ESCA = esophageal carcinoma, FPPP = FFPE pilot phase II, GBM = glioblastoma multiforme, GBMLGG = Glioma, GO = gene ontology, HNSC = head and neck squamous cell carcinoma, KIPAN = Pankidney cohort (KICH + KIRC + KIRP), KIRC = kidney renal clear cell carcinoma, KIRP = kidney renal papillary cell carcinoma, KM = Kaplan–Meier, LAML = acute myeloid leukemia, LGG = brain lower-grade glioma, LIHC = liver hepatocellular carcinoma, LUAD = lung adenocarcinoma, LUSC = lung squamous cell carcinoma, MESO = mesothelioma, NB = neuroblastoma, OS = osteosarcoma, OV = ovarian serous cystadenocarcinoma, PAAD = pancreatic adenocarcinoma, PCPG = pheochromocytoma and paraganglioma, PFI = progression-free interval, PPI = protein-protein interaction, PRAD = prostate adenocarcinoma, READ = rectum adenocarcinoma, SARC = sarcoma, SKCM = skin cutaneous melanoma, STAD = stomach adenocarcinoma, STES = stomach and esophageal carcinoma, TARGET = therapeutically applicable research to generate effective treatment, TCGA = the cancer genome atlas, THCA = thyroid carcinoma, THYM = thymoma, TMB = tumor mutation burden, TME = tumor microenvironment, twist1 = the twist family bHLH transcription factor 1, UCEC = uterine corpus endometrial carcinoma, UCS = uterine carcinosarcoma, UVM = uveal melanoma, WT = High-risk Wilms tumor. | | Keywords: immunotherapy, pan-cancer, the twist family bHLH transcription factor 1 , tumor immunity, tumor microenvironment | This work was supported by the Natural Science Foundation of Shandong Province [ZR2021MH136]; and Zhejiang Province Traditional Chinese Medicine Science and Technology Project [2023ZL6448]. The authors have no conflicts of interest to disclose. All data generated or analyzed during this study are included in this published article [and its supplementary inf

FAQs

What is the main purpose of this study on TWIST1?

To investigate TWIST1 roles and potential mechanisms across pan-cancer, and to determine whether it can serve as a biomarker for tumor immunity and prognosis.

How was TWIST1 expression validated in this work?

Fluorescence staining was performed to identify TWIST1 expression across various tumor masses.

What associations were found between TWIST1 and clinical outcomes?

TWIST1 expression was significantly higher in multiple cancer types and was associated with tumor stage, grade, and poor prognosis.

Sep 21, 2026

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