These factors were subjected to multivariate analysis, which indicated that tumor size (P = 0.006), depth of invasion (P = 0.007), lymph node metastasis (P < 0.001), TNM stage (P < 0.001), and FSTL1 expression (P = 0.002) were independent prognostic factors in GC patients. This evidence concerns the gene FSTL1 and metastatic malignant neoplasm in the lymph nodes.