In addition, it has been shown that there is a direct interaction between MEF2C and SOX18, that MEF2C enhances the transcriptional activity of SOX18, and that high expression of SOX18 plays an important role in the proliferation, apoptosis, migration, and invasion of OS cells.[45,46] This suggests that the 2 may have a synergistic effect in regulating the expression of vascular-related genes, which may play an important role in angiogenesis, tumor invasion, and metastasis of osteosarcoma, especially in the early stages of vascular and lymphatic vessel formation. This evidence concerns the gene SOX18 and osteosarcoma.