CSAG1 (chondrosarcoma associated gene 1) is an X-linked gene that plays a critical role in maintaining centrosome integrity during mitosis. The protein functions to preserve centrosome structure and promote proper spindle pole organization, essential for bipolar mitotic spindle formation and balanced chromosome X 1. CSAG1 depletion disrupts centrosomes and leads to multipolar spindles, particularly in cells with compromised p53 function, suggesting it represents a 'mitotic addiction' gene more critical in transformed cells 1. Clinically, CSAG1 has emerged as a potential biomarker in multiple malignancies. Differential expression and genomic alterations of CSAG1 were identified among ten hub genes associated with decreased survival in head and neck squamous cell carcinoma patients 2. In gastric cancer, CSAG1 was identified as one of the top ten metastasis-related genes correlated with patient prognosis 3. Recent Mendelian randomization analysis identified causal relationships between specific gut microbiota metabolic pathways (including tetrapyrrole biosynthesis, menaquinol 6 biosynthesis, and glycolysis) and CSAG1 expression in chondrosarcoma, suggesting microbiota-mediated mechanisms in cancer development 4. Additionally, CSAG1 was identified as a potential miRNA target in stomach adenocarcinoma, simultaneously targeted by miR-105-1, miR-105-2, and miR-767 5. These findings suggest CSAG1 warrants further investigation as a therapeutic target and prognostic marker.