Curiously, alterations of the sugar moieties of the glycosylated Lewis X and Lewis Y antigens are frequent in epithelial ovarian cancers and, besides having obvious prognostic implications, may be prime arbiters along with extracellular matrix component interactions (e.g., β-integrin/fibronectin, CA125/mesothelin, CD44/hyaluronan) in CD44-mediated adhesion and peritoneal spreading (metastasis) of ovarian cancer cells [242]. This evidence concerns the gene MSLN and ovarian cancer.