There was a trend towards increased NEP overexpression in visceral metastases versus skin and lymph node metastases (57% (4/7) of patients with visceral metastases, versus 40% (6/15) and 24% (6/25) of patients with skin and lymph node metastases, respectively, p = 0.08 by trend test). Here, MME is linked to metastatic malignant neoplasm in the lymph nodes.