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TGF-β and SDF-1 can alter CTC phenotype and behavior in the bone. The cytokine TGF-β and the chemokine SDF-1 are constitutively expressed in the bone microenvironment and control pathways related to cell adhesion and homing, EMT, MET, cell cycle, and tumorigenicity. It is currently unknown if inducible EMT or MET affects cancer cell expression of functional E-selectin ligands and thus CTC capacity to metastasize.
