Interestingly, higher Twist1 expression has been observed previously in patients with liver cirrhosis and HCC.15,42 In HCC, Twist1 mediates tumour invasion and metastasis by regulating epithelial to mesenchymal transition and its expression can be induced by EGF and TGF-β.43 In view of Twist1 being implicated in both liver fibrosis and HCC, investigation of Twist1 inhibitors to prevent the development of liver fibrosis and HCC is warranted for further study in pre-clinical animal models. This evidence concerns the gene TGFB1 and neoplasm.