Colorectal cancer (CRC) is the third common carcinoma with a high rate of mortality worldwide and several studies have investigated some molecular and clinicopathological markers for diagnosis and prognosis of its malignant phenotypes. The aim of this study is to evaluate expression frequency of PAGE4, SCP-1, and SPANXA/D cancer testis antigen (CTA) genes as well as some clinical risk markers to predict liver metastasis of colorectal cancer patients. The expression frequency of PAGE4, SCP-1, and SPANXA/D cancer/testis antigen (CTA) genes was obtained using reverse transcription polymerase chain reaction (RT-PCR) assay in 90 colorectal tumor samples including both negative and positive liver metastasis tumors. Statistical analysis was performed to assess the association of three studied genes and clinical risk factors with CRC liver metastasis. The frequency of PAGE4 and SCP-1 genes expression was significantly higher in the primary tumours with liver metastasis when statistically compared with primary tumors with no liver metastasis ( ). Among all clinical risk factors studied, the lymph node metastasis and the depth of invasion were statistically correlated with liver metastasis of CRC patients. In addition, using multiple logistic regression, we constructed a model based on PAGE4 and lymph node metastasis to predict liver metastasis of CRC. 1. Introduction Colorectal cancer (CRC) is the third common cancer and the fourth cause of mortality throughout the world [1]. Accumulating evidence shows that CRC can metastasise to many organs and CRC patients die mainly from metastatic disease. Liver is the preferential target of the CRC metastasis [2]. Nearly 10–25% of CRC patients on diagnosis have liver metastases. However, 20–50% of CRC patients with no detectable metastasis at the time of resection of the primary tumor will develop liver metastases later on [3–5]. Liver resection in CRC patients with liver metastasis remains the best treatment option and it is associated with a survival rate and a 20–25% of long-term survivors [6]. However, without treatment, the median overall survival is approximately 9 months after the recognition of liver metastases [6]. To boost the survival rate of CRC patients, selection of patients at high risk for liver metastasis is crucial. Two of the most important conventional pathological risk factors for diagnosis of colorectal liver metastasis (CLM) are lymph node metastasis and lymphatic invasion [7]. Molecular studies have shown that there are some useful markers for predicting CLM. Several tumor-associated antigens (TAAs)
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