MFAP2 (microfibril-associated protein 2) is a component of elastin-associated microfibrils within the extracellular matrix 1. In normal physiology, hepatic stellate cell-derived MFAP2 plays a protective role in liver fibrosis by regulating ECM composition and modulating inflammation; MFAP2 deficiency impairs fibrosis resolution through enhanced HSC interactions, ECM stabilization, and reduced macrophage recruitment 2. Additionally, MFAP2 is implicated in blood-brain barrier integrity in the context of amyotrophic lateral sclerosis 3. In cancer pathogenesis, MFAP2 is significantly upregulated across multiple malignancies. In esophageal squamous cell carcinoma, MFAP2 promotes metastasis by binding to focal adhesion kinase (FAK), alleviating intramolecular FAK inhibition and activating the FAK-AKT signaling pathway 4. In gastric cancer, elevated MFAP2 expression correlates with poor prognosis and promotes proliferation through PI3K/AKT pathway activation 5. MFAP2 also functions as an independent prognostic biomarker in gastric cancer and enhances cisplatin resistance by regulating autophagy 6. These findings establish MFAP2 as both a protector in tissue homeostasis and a pathogenic driver in cancer progression, with potential therapeutic implications.