TWIST1 and metastatic malignant neoplasm in the lymph nodes: In addition, TWIST over-expression has a correlation with lymph node metastasis (Yes vs No, OR = 3.40, 95% CI = 1.98–5.82) and distant metastasis (Yes vs No, OR = 5.67, 95% CI = 2.46–13.07), suggesting that TWIST might contribute to cancer development and progression (Fig. 3).