In the same study, Hirose et al. [175], using immunohistochemistry in patient gallbladder tissue, demonstrated that high expression of the activated SphK1 (phosphorylated-SphK1), but not SphK2, was elevated in BTC with lymph node metastasis (metastatic GBCs) but not associated with lymphangiogenesis. This evidence concerns the gene SPHK1 and metastatic malignant neoplasm in the lymph nodes.