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Circulating biomarkers in head and neck cancer. Circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and exosomal miRNAs are complementary biomarkers present in plasma and/or saliva. Apoptotic tumor cells release ctDNA into blood, whereas necrotic tumor cells shed ctDNA into saliva. Tumor cells release exosomal miRNAs into blood and saliva. Primary tumor and metastatic lesions release CTCs into blood.
