Objective:To investigate the relationship between the expression of Twist1 and Twist2 protein and with clinicopathological features in hypopharyngeal carcinoma.Methods:The clinical and pathological data of 58 patients with hypopharyngeal carcinoma who underwent surgery in Liaoyang Central Hospital from May 2014 to September 2019 were retrospectively analyzed. The general demographic and pathological data of the patients were collected, and the expression of Twist1 and Twist2 protein in the hypopharyngeal cancer tissues and adjacent tissues were detected by immunohistochemistry. The patients were followed up to record their survival. The relationship between protein expression of Twist1 and Twist2 and clinical pathological stages and prognosis was analyzed.Results:Immunohistochemistry showed that the positive expression rates of Twist1 and Twist2 protein in 58 patients with hypopharyngeal cancer were significantly higher than those in adjacent tissues ( P<0.05). The positive expression rates of Twist1 and Twist2 in patients with T stage T 3+ T 4 and clinical stage Ⅲ+ Ⅳ were significantly higher than those in patients with T 1+ T 2 and Ⅰ+ Ⅱ ( P<0.05). The positive expression rates of Twist1 and Twist2 in patients with lymph node metastasis were significantly higher than those without lymph node metastasis, and the positive expression rates of Twist1 and Twist2 in low differentiation were significantly higher than those in high differentiation ( P<0.05). 52 patients were followed up postoperatively, the follow-up rate was 89.67%, among which 28 patients recurred (53.85%), and the 1-, 3-, and 5-year survival rates were 80.77%(42/52), 53.85%(28/52), and 21.15%(11/52), respectively. The survival rate of patients with positive expression of Twist1 and Twist2 protein was significantly lower than that of patients with negative expression ( P<0.05). Multiple analysis showed that recurrence, tumor stage, positive expression of Twist1 and Twist2 protein were independent risk factors for survival ( P<0.05). Conclusions:The expression of Twist1 and Twist2 protein in hypopharyngeal carcinoma is stronger than that in normal tissues. The expression of Twist1 and Twist2 protein is related to T stage, clinical stage, pathological tissue type and lymph node metastasis. Meanwhile, the high expression of Twist1 and Twist2 proteins is an independent factor affecting the prognosis of patients. They may be potential indicators to judge the prognosis of patients with hypopharyngeal cancer.