CD4 and metastatic malignant neoplasm in the lymph nodes: Moreover, the CD4/CD8 ratio was significantly lower in tumors from patients with lymph node metastasis (n = 8) than in those without lymph node metastasis (n = 22, 0.50 versus 0.81, p = 0.001) and was much lower in bulky tumors (tumor size >4 cm, n = 5) than in non-bulky tumors (n = 25, 0.41 versus 0.81, p = 0.001).67