Abstract: Objective To explore the clinical significance of the expression of Twist in liver cancer tested by immunohistochemistry. Methods There were 136 clinical specimens of primary hepatocellular carcinoma (HCC) tissues from January 2013 to January 2017 in our hospital analyzed in the study, 85 of which contained paracarcinomatous tissues (< 3 cm away from HCC). The expression levels of Twist in HCC tissues and paracarcinomatous tissues were detected by immunohistochemistry, and the relationship of Twist expression to clinicopathological parameters and prognosis of HCC patients was analyzed. Results The positive staining area of Twist protein was mainly located in cytoplasm, which was distributed in patches, nests or a diffuse manner as brownish yellow granules. The positive expression rate of Twist protein in cancer tissues was 66.2%, significantly higher than 5.9% in paracarcinomatous tissues (P<0.05). Among 136 cancer tissue samples, 90 were Twist protein positive and 46 were negative. In Twist positive group, the rates of pathologic stage Ⅲ ~ Ⅳ, TNM stage Ⅲ ~ Ⅳ, poorly differentiated tumor cells, incomplete capsule and vascular invasion were 45.6%, 46.7%, 46.7%, 41.1% and 35.6%, significantly higher than 23.9%, 28.3%, 26.1%, 19.6% and 17.4% in Twist negative group (P<0.05). There was no significant difference in age, sex, tumor size or serum alpha-fetoprotein level between Twist positive and negative groups (P>0.05). And 3-year survival rate was 57.8% in Twist positive group and 65.2% in negative group, with no significant difference between. Conclusion Twist overexpression may be closely related to the occurrence, development and prognosis of primary HCC. And Twist is expected to a therapeutic target for primary HCC, which deserves more attention in clinical practice.

Key words: Immunohistochemistry, Hepatocellular carcinoma, Twist