EVs isolated from HCC cells can stimulate the phospho-extracellular regulated protein kinases (pERK)1/2 signaling and upregulate mitogen-activated protein kinase (MAPK) and Wnt in fibroblast cells, while EVs from fibroblast cells can notably increase the levels of SPOCK1 (also known as testican-1), a proteoglycan recognized as oncogenic, in HCC cells [75]. The gene discussed is SPOCK1; the disease is hepatocellular carcinoma.