Even among gastric carcinoma cases with a similar extent of lymphatic invasion, the number of diseased lymph nodes may vary. Other factors might also contribute to the process of lymphangitic metastasis. Primary gastric tumors with the same extent of pathologic lymphatic invasion were studied in 78 patients. We investigated the correlation between CD54 expression on cancer cells and clinicopathologic features. Decreased CD54 expression on cancer cells was significantly correlated with the number of involved lymph nodes and the extent of lymph node spread. The number of diseased lymph nodes was associated with the prognosis of patients with gastric carcinoma. The CD54-negative group had a significantly worse prognosis than the CD54-positive group. These findings suggested that CD54 expression is predictive for lymphatic spread and prognosis in human gastric carcinoma.