CD40 and metastatic malignant neoplasm in the lymph nodes: CD40 expression in breast and gastric cancers was associated with an earlier stage [39, 40], whereas in esophageal squamous cell carcinoma CD40 expression was associated with a more advanced pathological stage, poorer differentiation, and higher rates of lymph node metastasis, predicting an increased potential for tumor progression and metastasis [41].