Importantly, we identified new genes associated with this metastatic cell state including ANXA1, Kallikrein family, FKBP4, Serpin family, CD47, MDK and the sialyl-transferases ST3GAL4 and ST6GALNAC1. These genes have been implicated in cancer development and metastasis among other types of primary malignancies but not in appendiceal mucinous neoplasms. The gene discussed is KLK4; the disease is cancer.