Our nomogram was established based on important risk factors for lymph node metastasis screened through logistic regression, including elevated CA19-9 (greater than 200u/ml P = 0.019), elevated CEA (greater than 10 ng/ml P = 0.025), and lymphadenopathy on imaging (largest lymph node diameter greater than 0.1 cm P = 0.004). The gene discussed is CEACAM5; the disease is metastatic malignant neoplasm in the lymph nodes.