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. Author manuscript; available in PMC: 2020 Dec 29.
Published in final edited form as: Dev Cell. 2019 May 6;49(3):308–310. doi: 10.1016/j.devcel.2019.04.021

Figure 1. Interactions with Neutrophils Enhance CTC Proliferation and Metastatic Colonization.

Figure 1.

Tumor cells with mutations in specific genes, including TLE1, attract neutrophils to the primary tumor site and increase the number of CTC-neutrophil clusters in the bloodstream. Expression of the cell adhesion molecule VCAM1 in the tumor cells mediates the formation of CTC-neutrophil clusters, presumably by binding to specific integrins present in neutrophils. These neutrophils express IL6 and IL1β, signals that promote CTC cell-cycle progression. Conversely, CTCs express neutrophil-stimulating factors such as G-CSF. CTC-neutrophil clusters are highly efficient in initiating metastasis and their presence correlates with poor outcome.