Although a large-scale prospective study to prove the clinical significance for ACTN4 is necessary, we conclude that ACTN4 is a surrogate biomarker for predicting prognosis to support histological grading in salivary gland carcinoma and that the inhibition of the biological function of ACTN4 may impact a new therapeutic strategy for high-grade salivary gland carcinoma. The gene discussed is ACTN4; the disease is salivary gland carcinoma.