癌症患者高死亡率的主要原因是转移，即肿瘤细胞通过血流从原始部位迁移到身体的其他部位。最近的技术进步显着增强了我们对循环肿瘤细胞 (CTC) 血源性传播机制的理解。 DNA 甲基化是一个关键过程，可调节基因表达和染色体稳定性，从而维持体内的动态平衡。整体低甲基化和位点特异性高甲基化是对致癌作用至关重要的 DNA 甲基化模式变化的例子。这篇全面的综述首先概述了有助于 CTC 形成的各种过程，包括上皮间质转化 (EMT)、免疫监视和定植。然后，我们深入分析 CTC 内 DNA 甲基化的修饰如何影响 CTC 传播过程中的每个关键阶段。此外，我们还探讨了 CTC 中 DNA 甲基化变化对癌症患者的潜在临床影响。通过了解这些表观遗传修饰，我们可以深入了解转移过程，并识别用于早期检测、预后和靶向治疗的新生物标志物。本综述旨在弥合基础研究和临床应用之间的差距，强调 DNA 甲基化在癌症转移中的重要性，并为改善患者预后提供新途径。© 2024。作者。

The primary reason for high mortality rates among cancer patients is metastasis, where tumor cells migrate through the bloodstream from the original site to other parts of the body. Recent advancements in technology have significantly enhanced our comprehension of the mechanisms behind the bloodborne spread of circulating tumor cells (CTCs). One critical process, DNA methylation, regulates gene expression and chromosome stability, thus maintaining dynamic equilibrium in the body. Global hypomethylation and locus-specific hypermethylation are examples of changes in DNA methylation patterns that are pivotal to carcinogenesis. This comprehensive review first provides an overview of the various processes that contribute to the formation of CTCs, including epithelial-mesenchymal transition (EMT), immune surveillance, and colonization. We then conduct an in-depth analysis of how modifications in DNA methylation within CTCs impact each of these critical stages during CTC dissemination. Furthermore, we explored potential clinical implications of changes in DNA methylation in CTCs for patients with cancer. By understanding these epigenetic modifications, we can gain insights into the metastatic process and identify new biomarkers for early detection, prognosis, and targeted therapies. This review aims to bridge the gap between basic research and clinical application, highlighting the significance of DNA methylation in the context of cancer metastasis and offering new avenues for improving patient outcomes.© 2024. The Author(s).