These findings indicated that the MIR181A1HG in CRC cell-derived EVs could activate HSCs via the TGF-β/Smad2/3 signaling pathway and that these activated HSCs (α-HSCs) promoted CRLM by recruiting MDSCs and remodeling the ECM in the liver. The gene discussed is MIR181A1HG; the disease is colorectal carcinoma.