EpCAM positive circulating tumour cells would, by definition, retain a fair amount of epithelial characteristics. Does that mean that hey are not (very) invasive and do not have (much) stem cell/cancer initiating cell activity?
Good question. This implies the question of whether cells that do not have undergone epithelial-mesenchymal transition or do not not show stem cell features are able to yield distant metastases. I do not think that there is an answer. Definitely, metastases must not show EMT or stemness, yet they can have reverted again. If EpCAM measures relatively innocuous CTCs than other markers that detect cells that have undergone EMT should perform better.
part of the difficulty in answering this question is that EMT and MET both can occur. a cell's progeny can be shown to shuttle between both states. the research on EMT-MET transitions and the research on cancer stem cells, CSC, leaves the distinction or exact relationship between the two [EMT-MET states and stemness]. quite unclear. also complicating current understanding is the probability [based on review of current research data] that although we have a single term- CSC- does not mean that there is a single specific entity. there are probably a range of CSC's with a range of stem cell attributes
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