Differently, OTUD4 expression may be significantly upregulated in pancreatic ductal adenocarcinoma, and the overall survival time of low OTUD4-expressing patients was considerably longer than that of high-expressing patients, suggesting that OTUD4 may be a pro-carcinogenic gene in pancreatic ductal adenocarcinoma [64]. This evidence concerns the gene OTUD4 and pancreatic ductal adenocarcinoma.