NES and metastatic malignant neoplasm in the lymph nodes: Fig. 1b shows the quantitative ratio of nestin to β-actin expression. An increased nestin:β-actin ratio was found in the early stages of cancer without lymph node metastasis (T2N0 or T3N0) and in advanced cancer with lymph node metastasis (T4N1). However, the nestin:β-actin ratio was low in T2N1, T3N1 and T4N0 cancers (Fig. 1a). The fluctuating curve shown in Fig. 1b demonstrated the various function of nestin in early and advanced ampullary adenocarcinoma.