L1CAM and metastatic malignant neoplasm in the lymph nodes: However, stratification by lymph node metastasis revealed a significant difference: patients with lymph node metastasis had a mean L1CAM+ T-CTC count of 5.05 ± 6.987, which was significantly higher than that of patients without metastasis (2.58 ± 4.849, p = 0.048; Figure 4B).