H19 and metastatic malignant neoplasm in the lymph nodes: Furthermore, the median serum EV H19 levels were significantly lower in post-operative settings than that in pre-operative settings, whereas EV H19 expression levels were associated with lymph node metastasis, distant metastasis, TNM stages, ER, PR, and HER2 expression, results indicating that serum EV H19 may act as a novel biomarker for the diagnosis and monitoring of BC [173].