However, positive correlation was observed between Ki-67 and N stage and M stage as illustrated in Table 3, statistical analysis revealed that the SIRT3, SIRT4, MTUS1, OGG1-2a and Ki-67 expression levels in head and neck cancer patients is associated with lymph node status and metastasis status of HNSCC cases. The gene discussed is SIRT4; the disease is head and neck squamous cell carcinoma.