KRT23 (keratin 23) is an epithelial-specific intermediate filament protein involved in structural integrity and cellular signaling in epithelial tissues 1. Beyond its canonical role in cytoskeletal organization, KRT23 functions as a critical regulator of cancer-related processes across multiple tumor types. In colorectal cancer, KRT23 promotes hTERT expression and telomerase activity, driving proliferation and migration while supporting cancer stem cell properties 2. KRT23 depletion impairs DNA damage response pathways, including homologous recombination repair, rendering cancer cells more sensitive to radiation 3. In ovarian cancer, KRT23 overexpression mediates epithelial-mesenchymal transition (EMT) via TGF-β/Smad signaling, enhancing migration and invasion 4. In gastric cancer, KRT23 suppression enhances melatonin's antiproliferative effects by inhibiting p38/ERK phosphorylation 5. Beyond oncology, KRT23 polymorphisms (rs72826004, rs2269859) associate with metabolic dysfunction-associated fatty liver disease (MAFLD) risk, with elevated KRT23 expression observed in MAFLD patients and animal models 6. In bladder cancer, KRT23 emerges as a key immunotherapeutic target within immune checkpoint gene signatures 7. In endometriosis, KRT23 is expressed in ciliated epithelial cells undergoing EMT 8. These findings establish KRT23 as a multifunctional oncogene and metabolic regulator with therapeutic potential across diseases.