In pancreatic cancer, hypoxia inducible factor (HIF)-1α, which associated with patient's metastasis stage and lymph node metastasis, could directly bind to hypoxia-responsive element (HRE) located in Ob-R gene promoter (−828/−832) and activated the downstream transcriptional activation, suggesting the potential clinical significance of leptin receptor mediated axis [32]. This evidence concerns the gene LEPR and metastatic malignant neoplasm in the lymph nodes.