After adjusting for potential covariates, independent predictive factors for lymph node metastasis were identified as patient age less than 60 years old (OR:1.869, 95% CI: 1.505–2.321, p < 0.001), poorly differentiated or mucinous or SRC adenocarcinoma (OR:2.075, 95% CI: 1.584–2.717, p < 0.001), elevated CEA level (OR:1.343, 95% CI: 1.022–1.763, p = 0.033) and PNI (OR:6.212, 95% CI: 3.502–11.017, p < 0.001) (Table 2). The gene discussed is CEACAM5; the disease is adenocarcinoma.