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. 2019 Jul 3;11(7):934. doi: 10.3390/cancers11070934

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© 2019 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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The involvement of OCSCs in passive tumor dissemination (A–C) and in hematogenous metastasis (D). (A) The cancer cells at primary site may undergo EMT, gain stem cell properties, and disperse into ascites as either single cell or multicellular spheroids. (B) Ascites provides floating cells with a CSC-promoting microenvironment. (C) Adhesion to mesothelium is facilitated by CD44 and β1 integrin heterodimer on the surface of floating cells. (D) Activated ErbB3/NRG1 axis promotes hematogenous metastasis to omentum.