CDKN2A and metastatic malignant neoplasm in the lymph nodes: However, multivariate Cox proportional hazards model analyses, which included age, lymph node metastasis, distant metastasis, clinical stage, CBX7 protein expression and p16(INK4a) protein expression, showed that only lymph node metastasis was an independent prognostic indicator of overall survival, while CBX7 wasn't the independent prognostic indicator (Table 2).