To the best of our knowledge, predictive factors of lymph node metastasis, preoperatively, are central tumor localization [19], larger tumor size [19,20,21], age ⩽ 67 years [20], high CEA level [20,21], micropapillary predominant adenocarcinoma [21,22,23] and consolidation/tumor ratio ≥ 89% [20]. The gene discussed is CEACAM5; the disease is metastatic malignant neoplasm in the lymph nodes.