As a biomarker, LGR5 positivity in the Validation Cohort predicted the presence of lymph node metastasis with a 95.5% sensitivity (95% CI 88.8%–98.7%) and 61% specificity (95% CI: 48.4%–72.4%); it had a negative predictive value (NPV) of 91.3% (95% CI 79.2%–97.5%) for metastatic disease to lymph nodes. This evidence concerns the gene LGR5 and metastatic neoplasm.