// Zhi Li 1, 2 , Sohsuke Yamada 2, 9, 10 , Ying Wu 1 , Ke-Yong Wang 3 , Yun-Peng Liu 1 , Hidetaka Uramoto 4, 7 , Kimitoshi Kohno 5, 8 , Yasuyuki Sasaguri 2, 6 1 Department of Medical Oncology, The First Hospital, China Medical University, Shenyang, China 2 Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan 3 Bio-information Research Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan 4 Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan 5 The President Laboratory, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan 6 Laboratory of Pathology, Fukuoka Wajiro Hospital, Fukuoka, Japan 7 Division of Thoracic Surgery, Saitama Cancer Center, Saitama, Japan 8 Asahi-Matsumoto Hospital, Kitakyushu, Japan 9 Institute of Pathology, Medical University of Graz, Graz, Austria 10 Department of Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan Correspondence to: Yun-Peng Liu, email: cmuliuyunpeng@hotmail.com Sohsuke Yamada, email: sousuke@med.uoeh-u.ac.jp Keywords: GalNAc-T6, glycosylation, lung adenocarcinoma, prognosis, overall survival Received: March 02, 2016 Accepted: May 04, 2016 Published: June 03, 2016 ABSTRACT Background: Polypeptide N-acetylgalactosaminyltransferases (GalNAc-Ts) are important glycosyltransferases in cancer, but the clinical role of its individual isoforms is unclear. We investigated the clinical significance and survival relevance of one isoform, GalNAc-T6 in lung adenocarcinoma after curative resection. Results: GalNAc-T6 was identified in 27.8% (55/198) of patients, and statistically indicated advanced TNM stage ( P = 0.069). Multivariate analysis showed GalNAc-T6 to be an independent predictor for reduced overall survival of patients ( P = 0.027), and the result was confirmed with bootstraping techniques, and on line "Kaplan-Meier Plotter" and "SurvExpress" database analysis, respectively. Moreover, ROC curve demonstrated that GalNAc-T6 expression significantly improved the accuracy of survival prediction. Methods: With 198 paraffin-embedded tumor samples from lung adenocarcinoma patients, GalNAc-T6 expression was immunohistochemically assessed for the association with clinicopathological parameters. The prognostic significance was evaluated by Cox proportional hazards regression analysis with 1000 bootstraping. "Kaplan-Meier Plotter", "SurvExpress" database analysis, and receiver-operating characteristic (ROC) curve were performed to provide further validation. Conclusions: GalNAc-T6 expression correlated significantly with advanced TNM stage, and independently predicted worse OS for lung adenocarcinoma.