TWIST1 Study in Esophageal Cancer Retracted After Image Concerns

The editors of BMC Cancer have retracted a 2022 study that claimed to show how the transcription factor TWIST1 drives cancer stem cell properties and tumor growth in esophageal squamous cell carcinoma, one of the deadliest and most treatment-resistant malignancies worldwide. The retraction, published as a formal correction note in September 2026, ends a four-year saga in which concerns about duplicated microscopy images went unanswered by the authors, leaving the journal with no choice but to formally withdraw confidence from the paper’s data and conclusions.

The original study, published in December 2022 by researchers at Mashhad University of Medical Sciences in Iran and Amsterdam University Medical Centers in the Netherlands, had proposed a mechanistic link between TWIST1, a well-known developmental transcription factor, and the activation of cancer stem cell marker genes in esophageal cancer cells. The paper argued that TWIST1 promotes epithelial-mesenchymal transition, a biological program in which epithelial cells lose their polarity and adhesion properties and acquire invasive, mesenchymal characteristics, thereby fueling tumorigenesis in esophageal squamous cell carcinoma.

Esophageal squamous cell carcinoma is the most common form of esophageal cancer globally and remains one of the most aggressive solid tumors, with five-year survival rates often below 20 percent in many regions. The disease is particularly prevalent in parts of Asia, including the so-called esophageal cancer belt stretching from northern Iran through Central Asia to China, which is precisely where the research team was based. Understanding the molecular drivers of this cancer has been a major research priority, and TWIST1 had long been suspected of playing a central role in the epithelial-mesenchymal transition that allows esophageal cancer cells to invade surrounding tissue and metastasize to distant organs.

The retraction note, published by the editors of BMC Cancer, states that after the original publication, concerns were raised about similarities between several microscopy images presented in Figure 4 of the paper. Specifically, the editors noted that GFP-labeled YM-1 cells shown in panels 4B, 4D, and 4H were similar to GFP-labeled KYSE-30 cells shown in panel 4E. Additional similarities were noted between panels 4C and 4I, both showing GFP-labeled KYSE-30 cells, and between panels 4F and 4J, showing GFP-labeled YM-1 cells, and panel 4G, showing GFP-labeled KYSE-30 cells. Further concerns involved panel 4C, showing GFP plus TWIST1-transfected KYSE-30 cells, and panel 4D, showing GFP-labeled YM-1 cells at low magnification, as well as panels 4C, 4E, and 4G, showing GFP plus TWIST1-transfected KYSE-30 cells, and panel 4H, showing GFP-labeled YM-1 cells at medium magnification.

These image overlaps are significant because Figure 4 of the original paper was central to the study’s core claims about how TWIST1 affects cancer stem cell populations in esophageal cancer cells. The figure apparently presented fluorescence microscopy images of two different esophageal cancer cell lines, YM-1 and KYSE-30, some of which had been engineered to overexpress TWIST1. The purpose of these experiments was to demonstrate that forcing TWIST1 expression into esophageal cancer cells increases the population of cells expressing cancer stem cell markers, which are thought to be responsible for tumor initiation, resistance to chemotherapy, and relapse after treatment.

The retraction note makes clear that the authors did not respond to these concerns when raised by the editors. The editors state that they have therefore lost confidence in the data and conclusions of the article. Four of the authors named in the retraction note, Sima Ardalan Khales, Sina Mozaffari-Jovin, Dirk Geerts, and Mohammad Reza Abbaszadegan, did not respond to correspondence from the publisher about the retraction itself. The retraction note does not indicate whether any of the authors disputed the concerns or provided any explanation for the image similarities.

The original paper had been published as an open access article in BMC Cancer, a peer-reviewed journal that publishes research across all aspects of cancer research. The study had been cited by other researchers working on TWIST1, epithelial-mesenchymal transition, and cancer stem cells in esophageal cancer, meaning the retraction could affect how other groups interpret their own findings in this area. The retraction note does not state how many citations the paper received or whether any citing papers have been affected.

The retraction highlights a persistent challenge in cancer biology research, where fluorescence microscopy images are frequently used to demonstrate changes in cell populations, and where image duplication can be difficult to detect without sophisticated forensic analysis. In recent years, journals have increasingly turned to automated image integrity screening tools that can flag duplicated or manipulated images before or after publication. The concerns in this case were apparently raised after publication, and the fact that the authors did not respond to the editors’ queries meant the journal had no way to resolve the issues through clarification, correction, or author explanation.

Esophageal squamous cell carcinoma research has been particularly active in recent years, with multiple groups investigating the role of transcription factors like TWIST1, SNAIL, and ZEB1 in driving epithelial-mesenchymal transition and cancer stem cell properties. The retraction of this paper does not necessarily invalidate the broader hypothesis that TWIST1 plays a role in esophageal cancer progression, as other independent studies have examined similar mechanisms. However, the retraction does remove one specific piece of evidence from the literature, and researchers citing the original paper will now need to note that its data and conclusions have been formally withdrawn.

The retraction note, published in September 2026 as volume 26, article number 1090 of BMC Cancer, is available as an open access document under a Creative Commons license. The original article, published in December 2022 as volume 22, article number 1272, remains accessible online but is now clearly marked as retracted. The retraction note does not indicate whether any institutional investigation was conducted or whether any of the authors face further consequences. The editors of BMC Cancer have not issued any additional statements about the case beyond the formal retraction note.

Subject of Research: Retraction Note: TWIST1 activates cancer stem cell marker genes to promote epithelial‑mesenchymal transition and tumorigenesis in esophageal squamous cell carcinoma

Article Title: Retraction Note: TWIST1 activates cancer stem cell marker genes to promote epithelial‑mesenchymal transition and tumorigenesis in esophageal squamous cell carcinoma

Article References: Khales, S. A., Mozaffari‑Jovin, S., Geerts, D., & Abbaszadegan, M. R. (2026). Retraction Note: TWIST1 activates cancer stem cell marker genes to promote epithelial‑mesenchymal transition and tumorigenesis in esophageal squamous cell carcinoma. BMC Cancer, 26(1), Article 1090. https://doi.org/10.1186/s12885-026-16871-w

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16871-w

Keywords: Retraction, Note, TWIST1, activates, cancer, stem, cell, marker, genes, promote, epithelial, mesenchymal