TWIST1 and neoplasm: IL-6 and TNF-α can activate signaling pathways such as signal transduction molecules Smad and Wnt, which in turn activate transcription factors Snail family and Twist, prompting tumor cells to shift from epithelial to mesenchymal cell type, leading to a decrease in intercellular adhesion, shedding of tumor cells into the interrogative stroma and gaining the ability to easily metastasize to distant sites [44].