ZMYM4 is a zinc finger protein involved in cell morphology and cytoskeletal organization through protein and DNA binding 1. It functions as a B-MYB binding partner with potential roles in DNA damage response and G1/S-phase transitions 2. ZMYM4 is highly SUMOylated and its interaction with B-MYB is stimulated upon DNA damage induction 2. DISEASE RELEVANCE: ZMYM4 exhibits multiple alterations in gastrointestinal cancers, including frameshift mutations, intratumoral heterogeneity, and reduced expression specifically in microsatellite-instability-high gastric and colonic cancers 1. In hepatocellular carcinoma, ZMYM4 is significantly upregulated and promotes malignant progression through enhanced proliferation, migration, and invasion while suppressing apoptosis; miR-34a-5p directly targets ZMYM4 to inhibit these effects 3. ZMYM4 variants are associated with severe childhood obesity 4, schizophrenia through involvement in prenatal brain development 5, and post-traumatic stress disorder susceptibility 6. A ZMYM4 mutation was identified as a potential driver mutation in childhood acute myeloid leukemia relapse 7. CLINICAL SIGNIFICANCE: ZMYM4 serves as a potential prognostic biomarker for hepatocellular carcinoma and represents a therapeutic target, particularly through miR-34a-5p regulation 3.