The bivariate analysis demonstrated that a high level of several inflammatory markers such as neutrophil (p = 0.008; odds ratio [OR] = 2.296; 95%CI = 1.393–3.784), monocyte (p = 0.035; OR = 2.250; 95%CI = 1.562–3.242), ESR (p = 0.001; OR = 7.207; 95%CI = 1.092–47.577), CRP (p < 0.001; OR = 4.636; 95%CI = 1.610–13.350), NLR (p = 0.004; OR = 2.513; 95%CI = 1.283–4.919), ALP (p = 0.017; OR = 2.333; 95%CI = 1.592–3.421) and LDH (p = 0.001; OR = 3.273; 95%CI = 1.329–8.060) were significantly associated with the incidence of metastasis in osteosarcoma patients (Table 3). Here, ESR1 is linked to osteosarcoma.