ECM1 is a secreted glycoprotein with various functions, including stimulation of cell proliferation, promotion of angiogenesis, negative regulation of endochondral ossification, and facilitation of tumor progression.[61] Our results suggested that the number of osteoblasts surrounding tumor cells in the microenvironment of BMPC showed no significant change before and after the development of ENZ resistance. This evidence concerns the gene ECM1 and neoplasm.