Similarly, SEMA4A and VEGFR3 expression in PBMCs was also downregulated significantly in cases with T3 (p = 0.020 & 0.021) and T4 (p = 0.037 & 0.005) tumor sizes compared to T1, however, tumors with size T2 did not show any significant difference in relation to both SEMA4A and VEGFR3 expression in PBMCs compared to cases with T1 size tumors (Fig. 4b and c). This evidence concerns the gene FLT4 and neoplasm.