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Updated: Jun 23, 2026

Induction and Analysis of Epithelial to Mesenchymal Transition
Published on: August 27, 2013
Expression of the transcription factor snail and its target gene twist are associated with malignancy in
Jens Waldmann1, Emily P Slater, Peter Langer
1Department of Surgery, Philipps-University Marburg, Marburg, Germany. jwaldman@med.uni-marburg.de
Background:
One of the best known functions of the zinc-finger transcription factor Snail is to induce epithelial-mesenchymal transition (EMT). Twist, a target genes of Snail, is known to promote the development of distant metastases in mice. Increasing evidence suggests that EMT plays a pivotal role in tumor progression and metastatic spread.
Methods:
Snail, Twist, and E-cadherin expression were assessed by immunohistochemistry and real-time quantitative reverse transcriptase-polymerase chain reaction in 12 malignant and 35 benign pheochromocytomas (PCC). Data were correlated with clinical characteristics and genetics.
Results:
We found Snail expression in 13 (28%) of 47 primary PCC samples. Twist was expressed in 31 (66%) of 47 cases. Only one of 47 PCC showed E-cadherin expression. We observed Snail expression in 7 (58%) of 12 malignant PCC, whereas only 6 (17%) of 35 apparently benign PCC revealed Snail expression (P = 0.01). Furthermore, 11 (92%) of 12 malignant PCC, but only 20 (57%) of 35 benign PCC, revealed Twist expression (P = 0.03). Interestingly, all five metastases showed Snail and Twist expression. In normal adrenal medulla, Snail, Twist, and E-cadherin expression could not be detected.
Conclusions:
We describe for the first time that EMT markers Snail and Twist are expressed in PCC and that their expression is associated with malignancy. Our study supports a role for EMT in the malignant transformation of PCC.
Insights
Epithelial-mesenchymal transition (EMT) markers Snail and Twist are expressed in pheochromocytomas (PCC). Their increased expression correlates with malignant PCC, suggesting a role in tumor progression.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Epithelial-mesenchymal transition (EMT) is induced by the zinc-finger transcription factor Snail.
- Twist, a Snail target gene, promotes metastasis.
- EMT is increasingly recognized for its role in tumor progression and metastasis.
Purpose of the Study:
- To investigate the expression of EMT markers Snail and Twist in pheochromocytomas (PCC).
- To correlate Snail and Twist expression with PCC malignancy and clinical characteristics.
Main Methods:
- Immunohistochemistry and real-time quantitative reverse transcriptase-polymerase chain reaction were used to assess Snail, Twist, and E-cadherin expression.
- The study included 12 malignant and 35 benign PCC samples.
- Expression data were correlated with clinical and genetic features.
Main Results:
- Snail was expressed in 28% of PCC, with higher expression in malignant (58%) versus benign (17%) cases (P = 0.01).
- Twist was expressed in 66% of PCC, significantly higher in malignant (92%) versus benign (57%) cases (P = 0.03).
- E-cadherin expression was minimal, and both Snail and Twist were detected in all PCC metastases.
Conclusions:
- Snail and Twist expression is reported for the first time in PCC.
- Increased Snail and Twist expression is associated with PCC malignancy.
- These findings support a role for EMT in the malignant transformation of PCC.
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