TGM2 and neoplasm: Multiple studies have shown elevated TG2 expression in many types of cancer cells9 to be associated with increased drug resistance, metastasis, and poor patient survival (Table 4).33, 142 For example, an analysis of more than 30,000 genes from tumor samples revealed that TG2 is a highly expressed gene in pancreatic adenocarcinoma.143 An important property of the highly malignant tumor cells is their ability to survive in hostile host environments as they passes through the lymphatic system or the bloodstream in their attempt to colonize distant sites.