By screening mouse monoclonal antibody libraries for Kelch repeats, we serendipitously identified monoclonal antibodies to eukaryotic elongation factor 2 (eEF2). Interestingly, eEF2 was highly expressed in lung adenocarcinoma (LADC), but not in the neighboring non-tumor lung tissue. Normally, eEF2 is involved in the peptidyl-tRNA translocation during protein synthesis. Overexpression of eEF2 would implicate an association with disease progression of LADC. In the present study, we investigated the prognostic significance of eEF2 in patients with LADC. Expression of eEF2 was detected by immunoblotting, immunohistochemistry and confocal immunofluorescence microscopy. Our results show that patients with high eEF2 expression had a significantly higher incidence of early tumor recurrence (67.8% vs 18.2%, P = 0.016), and a significantly worse prognosis (P < 0.001). In an in vitro study, silencing of eEF2 expression increased mitochondrial elongation, cellular autophagy and cisplatin sensitivity. Moreover, eEF2 was sumoylated in LADC cells, and eEF2 sumoylation correlated with drug resistance. These results suggest that eEF2 is an anti-apoptotic marker in LADC. However, biological function and involvement of eEF2 in the disease progression of LADC require further studies. (Cancer Sci 2011; 102: 1582-1589 H igh metastatic potential and cell growth rate, as well as resistance to irradiation and anticancer chemotherapeutic agents are major characteristics of lung adenocarcinoma (LADC).(1) To determine whether the malignant characteristics correlated with specific gene expression, we had used different methods to screen gene expression profiles, and we identified several genes of interest such as dihydrodiol dehydrogenase, hepatocyte growth factor (HGF), HGF receptor (or c-Met, a product of proto-oncogene c-met), dynamin-related protein 1 (DRP1) and ATPase family, AAA domain containing 3A (ATAD3A).(2-6) Among these genes, the protein level, but not the mRNA level, of ATAD3A was increased when LADC cells were exposed to the hypoxic condition, suggesting that translation efficacy was altered under such circumstance. (6,7) Protein translation factors, for example, eukaryotic protein initiation factor 4E (eIF4E) and protein elongation factor 1A2 (eEF1A2), have been shown to be associated with oncogenesis. (8,9) Their expression correlates with tumor cell growth, invasion, metastasis and hence a poor prognosis in lung, breast, ovarian cancer and acute myeloid leukemia.(10-13) When screening mouse monoclonal antibody libraries for Kelch repeats, (14) we serendipitously found monoclonal antibodies to eukaryotic elongation factor 2 (eEF2), a 95 kDa protein that catalyzed translocation of peptidyl-tRNA on the ribosome during the elongation phase of translation.(15) However, the effect of eEF2 has not been determined in LADC.In this report, we studied eEF2 expression in LADC specimens by immunoblotting and immunohistochemistry. We statistically evaluated the correlation between eEF2 expression and clinicopathological parameters, as w...