Multivariate analysis showed that not only worse differentiation (adjusted HR=1.774, P=0.005), larger tumor size (adjusted HR=1.930, P=0.001) and more lymph node metastases (adjusted HR=2.201, P=0.009), but also lower Alb (adjusted HR=1.614, P=0.014), pAlb (adjusted HR=2.111, P<0.001), AFR (adjusted HR=1.540, P=0.044) and higher CEA (adjusted HR=1.739, P=0.013), FPR (adjusted HR=2.325, P=0.002) were identified as independent prognostic factors for shorter OS, but age, Fib and CA199 were not (P>0.05) (Table 3). The gene discussed is TTR; the disease is metastatic malignant neoplasm in the lymph nodes.