The random-effects model for five parameters showed that a high FAP-α expression was associated with blood vessel invasion (OR: 3.04, 95% CI: 1.54-5.99, <i>I</i> <sup>2</sup> = 63%, <i>P</i> = 0.001), lymphovascular invasion (OR: 3.56, 95% CI: 2.14-5.93, <i>I</i> <sup>2</sup> = 0.00%, <i>P</i> < 0.001), lymph node metastasis (OR: 2.73, 95% CI: 1.96-3.81, <i>I</i> <sup>2</sup> = 65%, <i>P</i> < 0.001), and distant metastasis (OR: 2.59; 95% CI: 1.16-5.79, <i>I</i> <sup>2</sup> = 81%, <i>P</i> < 0.001). Here, FAP is linked to metastatic malignant neoplasm in the lymph nodes.