Indeed Lai and coworkers showed that the Sirt4 levels in esophageal squamous cell carcinoma (ESCC) tissues from Chinese patients were higher than those in adjacent esophageal normal tissues and that the levels of the protein correlate inversely with the mean survival time of ESCC patients (48) (Table 1). The gene discussed is SIRT4; the disease is esophageal squamous cell carcinoma.