High TWIST1 mRNA expression is associated with poor prognosis in lymph node-negative and estrogen receptor-positive human breast cancer and is co-expressed with stromal as well as ECM related genes

Table 2 Model for uni-and multivariate analysis for metastasis-free survival in all patients (n = 1,427)

Factors	No. patients		Univariate			Multivariate
		HR	95% CI	P-value	HR	95% CI	P-value
Age (years)
<40	188	1			1
41 to 55	530	0.92	0.73 to 1.16	0.47	0.88	0.69 to 1.12	0.30
56 to 70	471	1.02	0.80 to 1.29	0.88	0.85	0.59 to 1.21	0.36
>70	238	0.80	0.66 to 1.06	0.12	0.69	0.47 to 1.03	0.07
Menopausal status
Premenopausal	603	1			1
Postmenopausal	824	1.07	0.92 to 1.25	0.35	1.23	0.94 to 1.62	0.14
Tumor size
pT1, <2 cm	463	1			1
pT2, >2 to <5	807	1.65	1.39 to 1.97	<0.001	1.38	1.15 to 1.65	<0.001
pT3, >5 + pT4	157	2.80	2.20 to 3.58	<0.001	1.80	1.39 to 2.33	<0.001
Lymph nodes involved
0	778	1			1
1 to 3	288	1.79	1.48 to 2.17	<0.001	1.71	1.41 to 2.08	<0.001
>3	361	2.92	2.46 to 3.46	<0.001	2.63	2.19 to 3.16	<0.001
Grade
Poor	800	1			1
Good/Moderate	230	0.51	0.40 to 0.65	<0.001	0.64	0.50 to 0.82	<0.001
Unknown	397	0.89	0.75 to 1.05	0.17	0.99	0.83 to 1.17	0.87
ER status (mRNA)
Negative	360	1			1
Positive	1,067	0.82	0.70 to 0.97	0.02	0.83	0.67 to 1.04	<0.001
PGR status (mRNA)
Negative	572	1			1
Positive	855	0.75	0.64 to 0.87	<0.001	0.87	0.71 to 1.06	0.17
ERBB2 status (mRNA)
Negative	1,187	1			1
Positive	240	1.30	1.08 to 1.57	0.006	1.18	0.97 to 1.43	0.09
					Addition to the base model
*TWIST1* mRNA level^† (Continuous)	1,427	1.17	1.09 to 1.26	<0.001	1.17	1.08 to 1.26	<0.001
*TWIST1* mRNA level ^†
TWIST1 quartile 1	360	1			1
TWIST1 quartile 2	355	1.16	0.94 to 1.45	0.17	1.09	0.88 to 1.37	0.43
TWIST1 quartile 3	357	1.22	0.98 to 1.51	0.08	1.25	1.00 to 1.56	0.05
TWIST1 quartile 4	355	1.49	1.20 to 1.83	<0.001	1.43	1.15 to 1.77	0.001

†TWIST1 mRNA expression level (log-transformed after normalization to the expression of three reference genes) was separately added to the base multivariate model that included the factors age, menopausal status, tumor size, grade, lymph-node status, ER, PGR, and ERBB2 mRNA expression levels, tested both as a continuous variable and in four quartiles.

ISSN: 1465-542X