Further multivariable Cox regression identified positive CLDN18.2 expression (HR = 2.229, 95% CI = 1.125-4.415; P = 0.022), large tumor size, advanced TNM stage, poor histological grade, MVI and lymph node metastasis as independent prognostic factors for disease recurrence (Table 3, all P < 0.05). Here, CLDN18 is linked to metastatic malignant neoplasm in the lymph nodes.