In consideration of the clinical features, CD44 expression was also associated with larger tumor size (RR = 1.39, 95% CI 1.17 - 1.64) and lymph node metastasis (RR = 1.98, 95% CI 1.33 - 2.95) in pharyngolaryngeal cancer of Asian patients; however, this phenomenon was not found in European patients, which may due to the limited number of European articles. This evidence concerns the gene CD44 and metastatic malignant neoplasm in the lymph nodes.