In the total cohort, higher α-SMA stromal expression was correlated with left-sided tumors (P = .01), higher T stages (P = .000324), vascular invasion (P = .047), perineural invasion (P = .003), infiltrative tumor edge pattern (P = 2.8301 × 10–8), higher N stages (P = .022), involved nodal status (P = .007), disease recurrence (P = .000156), metastasis (P = .005), synchronous metastasis (P = .005), and proficient MMR status (P = 5.2223 × 10–8) (Supplementary Table 2). Here, ACTA1 is linked to neoplasm.