Higher PME/ATP, PME/Pi, and PME/PDE ratios indicate an increase in cell proliferation and energy metabolism, which is characteristic of tumor tissue or treatment (McKenzie et al., 2005; van der Kemp et al., 2014; Schmitz et al., 2017; Krikken et al., 2019; Meyerhoff et al., 1992; Cox et al., 1992) also reported that an elevated PME/ATP ratio, reduced ATP and Pi concentrations, and normal PDE concentrations were observed in HCC when compared to normal control livers. The gene discussed is ALDH7A1; the disease is hepatocellular carcinoma.