Using this analysis, ranking the output by the mean of the JACKS score at 19 days minus the mean of the JACKS score at 4 h, the top two genes were Lrrn4cl and Tm4sf19. Tm4sf19 (transmembrane 4L six family member 19, also known as Octm4) is a member of the four-transmembrane L6 superfamily, which includes TM4SF1, whose overexpression in many cancers is associated with poor prognosis, and has roles in proliferation, invasion, and metastasis24. This evidence concerns the gene TM4SF19 and cancer.