Nevertheless, the findings from our univariate analysis revealed that only was the mean IRS of ADAM9 significantly increased in OSCC specimens with pTNM stages III and IV, large tumor size, and the presence of cervical lymph node metastasis, which is in line with our previous in vitro finding that demonstrated involvement of ADAM9 with oral cancer cell invasion [37]. This evidence concerns the gene ADAM9 and metastatic malignant neoplasm in the lymph nodes.