Introduction

Colorectal cancer (CRC) is considered to be the third most common malignancy worldwide, It is the fourth cause of cancer related death. Epithelial mesenchymal transition (EMT) plays a pivotal role in tumor invasion and metastasis. Recent studies have linked Twist-1 expression with EMT in different cancer cells including CRC bonding its expression with a more aggressive tumor phenotype and a poorer clinical outcome. The EMT phenotype has been also implicated in the acquisition of cancer stem cell (CSC) like properties. CD44 is believed to represent one of the main colorectal cancer stem cell markers. It plays a role in tumorigensis through stimulating several signaling pathways that maintain stemness of malignant tumors. Thus, Twist-1 and CD44 represent potential prognostic markers.

Aim of the Work

The current work was carried out to study the immuno-histochemical (IHC) expression of both Twist-1 and CD44 in CRC and to correlate this expression with the different clinicopathologic parameters and patients' outcome .