PDK4 and cancer: Imbalanced JAM2 gene expression has been correlated with GC staging, differentiation, and progression [70]; the pyruvate dehydrogenase kinase encoded by the PDK4 gene is a crucial enzyme that maintains a high rate of glycolysis in cancer cells, promoting resistance to apoptosis, it has been shown to enhance proliferation and invasion of GC tumor cells and is associated with infiltrations of B cells, CD4+ T cells, and dendritic cells, making it an adverse prognostic factor in GC [71], which aligns with our findings.