CD44 and squamous cell carcinoma: In NPC 90% of the histopathological type is squamous cell carcinoma (SCC), which is aggressive and has a high recurrence rate.25 Cluster of differentiation 44 (CD44) is a transmembrane adhesion receptor which is an intermediary for cellular interactions with the tumor microenvirontment that plays a role in the invasion and spread of tumor cells.26,27 CD44 expression is associated with cellular invasion and metastasis of cancer cells caused by reorganization of the cytoskeleton to facilitate active migration.