MiRNA-449a is considered as a tumor suppressive miRNA, with a remarkably decreased expression level in cancers.[25] It has been showed that downregulated miR-449a expression was related advanced clinical stage and poor histological differentiation of CRC.[26] In perspective of underlying mechanism, miR-449a inhibits the growth and metastasis of CRC cells by targeting Notch-1, HADC-1, and SATB2.[27,28] However, no studies have investigated the value of circulating miR-449a level in CRC patients. Here, NOTCH1 is linked to colorectal carcinoma.