Abstract: Objective To study the expression of glucose-regulated protein 78 (GRP78) in pancreatic ductal adenocarcinoma (PDCA) and its clinical signifcance. Methods GRP78 expression levels in pancreatic cancer and its adjacent tissue samples from 30 PDCA patients were measured by immunohistochemistry. Relation between GRP78 protein expression levels and clinicopathological parameters of PDAC patients was analyzed. Results Immunohistochemistry showed that the GRP78 expression level was signifcantly higher in pancreatic cancer tissue samples than in its adjacent tissue samples (73.3% vs 23.3%, P< 0.05). Univariate analysis displayed that the prognosis was poorer in patients with a higher GRP78 expression level than in those with a lower expression GRP78 level (P< 0.05). Western blot revealed that the GRP78 expression level was signifcantly higher in poorly and moderately differentiated pancreatic cancer cells than in highly differentiated pancreatic cancer cells (P< 0.05). Conclusion High GRP78 expression level in pancreatic cancer tissue may participate in the development and progression of PDAC, thus contributing to predicting the prognosis of PDAC.