In patients with N1b disease, 33 patients had macroscopic gross extrathyroidal extension, 24 patients had pathologic N1 with any metastatic lymph node >3 cm in largest dimension, 14 patients had postoperative serum thyroglobulin suggestive of distant metastases (greater than 10 ng/mL)1, or 1 patient had follicular thyroid cancer with extensive vascular invasion (>4 foci of vascular invasion). The gene discussed is TG; the disease is thyroid gland follicular carcinoma.