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Objective:The purpose of this study was to investigate the expression of Twist in salivary adenoid cystic carcinoma (SACC) and the relations between Twist expression and the clinicopathological characteristics.Methods:The expression of Twist was examined immunohistochemically in 48 cases of SACC,18 of pleomorphic adenoma and 10 of normal parotid gland.The relationship between Twist expression in SACC and the clinicopathological factors was analyzed.Results:Twist expression was significantly higher in SACC tissues compared with pleomorphic adenomas and normal parotid gland tissues (P＜0.05).Twist expression levels in SACC were significantly associated with histological type,perineural invasion,postoperative recurrence,and distant metastasis (P＜0.05),rather than age,gender,tumor site,tumor size,or clinical staging (P＞0.05).Conclusion:Twist expression may be associated with tumor cell differentiation,pedneural invasion and metastasis of SACC.Twist expression is a potential prognostic factor for disease survival of SACC.