SPON2 and metastatic malignant neoplasm in the lymph nodes: To further study the independent prognostic factors in ADC patients, the results of multivariate analysis showed that differentiation (HR, 0.802; 95%CI: 0.647–0.994; P =.044), positive lymph node metastasis (HR, 0.512; 95%CI: 0.358–0.732; P <.001), clinical stage (pTNM stage III–IV; HR, 1.433; 95%CI: 0.943–2.177; P <.001), higher SPON2 expression (HR, 1.626; 95%CI: 1.063–2.486; P =.025) (Table 3) were independent prognostic indicators for overall patient survival.