As shown in Table 1, patients with high COTE1 IRS were more likely to have elevated carcinoembryonic antigen (CEA) level (P = 0.037), worse histologic differentiation (P = 0.003), lymphatic metastasis (P < 0.001), vascular invasion (P = 0.012), and multiple focus (P = 0.027). The gene discussed is CEACAM5; the disease is Lymphatic Metastasis.