Importantly, we found that higher and lower expression levels of PAK4 and HMGCS2 in tumor tissues in HCC patients were associated with poorer survival rates, consistent with previous reports showing that aberrant expression of PAK4 is associated with tumor progression or invasion17 and that low levels of HMGCS2 and ketone bodies correlate with disease progression in HCC41. This evidence concerns the gene PAK4 and hepatocellular carcinoma.