Background: NCK-associated protein 1 may have tumor-promoting or suppressive impacts according to the type of tissue involved. TGFβ1 promotes tumor invasion and metastasis by inducing EMT. NCKAP1 may enhance EMT through promoting the activities of TGFβ1. Angiopoietin-like protein 1 was suggested to be a tumor suppressor through lessening the expression of stem cell transcription factor SOX2 in CRC cases, which reduces the invasive and metastatic abilities of tumor cells, so the aim of this current study explores the effect of each of the following biomarkers (NCKAP1, ANGPTL1, TGFβ1 and SOX2) on CRC prognosis and its clinical outcome, which could help in novel treatments development against CRC.

Methods: Seventy-two CRC tissue blocks were obtained retrospectively spanning the period between January 2019 and December 2023. CRC tissue sections are then exposed to all steps of IHC technique for staining of NCKAP1, ANGPTL1, TGFβ1 and SOX2.

Results: Positive ANGPTL1 expression was significantly correlated with good clinical parameters, less mortality rates and better prognosis in CRC patients. On the other hand, SOX2, NCKAP1 and TGFB1 were significantly correlated with poor prognosis and negatively associated with ANGPTL1 in CRC patients.

Conclusion: ANGPTL1 can be considered as a good prognostic indicator in CRC patients while the other three biomarkers SOX2, NCKAP1 and TGFB1 could act as worse outcome indicators and blockage of which markers could be beneficial in preventing CRC progression.