Wnt signalling is believed to be an important contributor to tumor development and has been reported to be modulated by secreted frizzled-related proteins (SFRPs). Nevertheless, the role of SFRP4 in tumorigenesis remains controversial. We aim to explore its biological function in gastric cancer. Genomes analysis based on GEO dataset was used to find the differential gene expression between different TNM stages of gastric cancer. Immunohistochemistry was used to determine the relationship between SFRP4 expression and clinicopathological characteristics in gastric cancer patients. The influence of SFRP4 on tumor progression was evaluated by CCK-8, colony formation, cell apoptosis and cell cycle in vitro, as well as xenograft model in vivo. The methylation status of SFRPs was examined in gastric cancer specimens by quantitative methylation analysis. SFRP4 was most upregulated in advanced gastric cancer. High intratumoral SFRP4 expression, which was associated with tumor invasion and metastasis, was also a poor prognostic indicator for gastric cancer patients. In vitro and in vivo studies revealed that SFRP4 could promote tumor growth, however, IWR-1 could suppress tumor growth mediated by SFRP4 overexpression. Mechanistic exploration found that SFRP4 was overexpressed by the decrease of promoter methylation and thus could competitively antagonize the inhibitory effect of SFRP1 on Wnt pathway activation and tumor progression in gastric cancer. Implications: In gastric cancer, the expression of SFRP4 was upregulated by decreased methylation. High intratumoral SFRP4 expression could activate the Wnt pathway to promote tumor progression and predict poor survival of gastric cancer patients.

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