Multivariate analysis showed that STAS positive was correlated with pleural invasion (P=0.001), vascular invasion (P<0.001), lymph node metastasis (P=0.005)and ALK protein expression (P=0.032).<h4>Conclusions</h4>STAS is associated with highly aggressive biological behavior of lung adenocarcinoma, suggesting a poor prognosis. The gene discussed is ALK; the disease is lung adenocarcinoma.