In this study, we found that consistent with the aggressive clinicopathologic characteristics of SPA (lower degree of differentiation, higher rate of lymph node metastasis, and higher pathological stage), SPA was associated with significantly lower TTF-1 and Napsin-A expression as well as higher proliferation score and Ki67 expression. Here, MKI67 is linked to metastatic malignant neoplasm in the lymph nodes.