On the other hand, multivariate analysis showed that higher preoperative CEA level (>2.43, OR: 2.093; 95% CI, 1.233–2.554; P = 0.006), presence of preoperative symptoms (OR: 2.737; 95% CI, 1.194–6.277; P = 0.017), lymph node enlargement (OR: 2.100; 95% CI, 1.243–3.550; P = 0.006), and advanced gross aspect (OR: 13.103; 95% CI, 7.689–23.330; P < 0.001) were independent predictors of occult locally advanced ESCC (Table 4). The gene discussed is CEACAM5; the disease is esophageal squamous cell carcinoma.