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. 2022 Aug 18;12:944487. doi: 10.3389/fonc.2022.944487

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Copyright © 2022 Chen, Zou, He, Pan, Yang, Zhao, Huang, Zhao, Wang, Chen and Lu

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Metastasis of circulating tumor cells (CTCs) and CTC clusters Cancer cells fall off from the primary sites and enter the blood circulation. They can exist by the form of single cells or aggregated cell clusters. There are various factors in peripheral blood (PB) that are not conducive to the survival of cancer cells. Cancer cells will be attacked by fluid shear stress and immune system, and signal CTCs also induce apoptosis due to the loss of intercellular contact. Finally, they reach distant organs and continue to spread, and CTC clusters have stronger metastatic potential compared to signal CTCs.