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CTCs enriched from a CRC patient undergoing metastasectomy with a simple centrifugation technique (OncoQuick®) were cultured directly. Further staining revealed large CTCs that were pan-cytokeratin+ (left image), DAPI+ (right image) and also expressed macrophage marker CD14 (middle image) in addition to leucocyte marker CD45 (not shown). We hypothesize that CTCs capable to spread and replicate in other organs induce immune tolerance by fusing with tumor-associated macrophages.
