COL10A1 encodes type X collagen, a structural protein primarily produced by hypertrophic chondrocytes and localized to mineralization zones in cartilage, conferring tensile strength to the extracellular matrix 1. In normal physiology, COL10A1 expression marks chondrocyte hypertrophy during endochondral ossification; dysregulation of this process contributes to skeletal dysplasias including Schmid type metaphyseal chondrodysplasia 2. COL10A1 serves as a biomarker for myofibroblast cancer-associated fibroblasts (CAFs) across solid tumors 3. In cancer pathophysiology, COL10A1 upregulation promotes tumor progression through multiple mechanisms: it facilitates epithelial-mesenchymal transition (EMT) in colorectal and breast cancers via secretion and signaling pathways including COL10A1/CD18/JAK1/STAT3 and lncRNA HAGLROS/miR-135b-3p axes 45. COL10A1 activates TGF-Ξ²1/Smad, MEK/ERK, and focal adhesion kinase signaling, driving cancer cell proliferation, invasion, and migration 1. In cartilage degeneration, COL10A1 upregulation indicates hypertrophic differentiation; miR-26b-5p-mediated COL10A1 suppression alleviates osteoarthritis by inhibiting chondrocyte hypertrophy 6. COL10A1 represents a potential therapeutic target in both cancer and degenerative joint disease, though clinical validation remains ongoing 1.