Circulating tumor cells (CTCs) are pivotal in cancer metastasis and serve as valuable
biomarkers for diagnosis, prognosis, and treatment monitoring. Traditional CTC capture
methods predominantly utilize the epithelial cell adhesion molecule (EpCAM) as a marker
for isolation. However, the heterogeneity of these circulating cells and the epithelial-to-mesenchymal
transition process (wherein epithelial cells acquire mesenchymal characteristics)
limit the efficacy of EpCAM-based capture techniques. In this paper, we critically
review the role of the EpCAM in CTC capture, explore the impact of epithelial-to-mesenchymal
transition on EpCAM expression, and discuss alternative biomarkers and strategies
to enhance CTC isolation. By evaluating the limitations of EpCAM-mediated capture
and the challenges posed by epithelial-to-mesenchymal transition, we aim to provide
insights into the development of more comprehensive liquid biopsy approaches for cancer
management.
