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ESAM is a tight junction regulatory protein involved in cell adhesion and is expressed only on endothelial cells and activated platelets. It may mediate aggregation through a homophilic molecular interaction (By similarity). ESAM at endothelial tight junctions participates in the migration of neutrophils through the vessel walls and it may have a role in signaling mechanisms that trigger the opening of endothelial cell contacts. A correlation has been found between ESAM expression and lymph node metastasis.