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Proposed mechanisms of cancer metastasis. Following detachment from the primary site, the cancer cells in circulation utilize three possible routes to metastasize: (a) direct binding to selectins on activated endothelium at distant sites using sLex and/or selectin expressed on the surface of cancer cells; (b) enlisting the help of circulating leukocytes via interaction of sLex with L-selectin present on the surface of leukocytes; (c) utilizing the help of platelets and leukocytes [121].
