Our findings suggest the following biological implications: loss of p53 protein or E-cadherin is an early event during oncogenesis and therefore not predictive of a metastatic behaviour (Van der Wurff et al, 1992), whereas CD44 (v6) and Ep-CAM are late events, since Ep-CAM is positive in lymph node metastasis in patients with loss of Ep-CAM at the invasive front (unpublished observations). Here, CD44 is linked to metastatic malignant neoplasm in the lymph nodes.