After adjusting for possible confounders (age, BMI, tumor size, lymph node metastasis, adjuvant chemotherapy, adiponectin, HOMA-IR and estradiol), the Cox proportional hazards regression analysis revealed a linear relationship between serum PGRN levels and breast cancer recurrence in the HR-positive group (p for trend  = 0.049; Table 2). The gene discussed is GRN; the disease is metastatic malignant neoplasm in the lymph nodes.