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Figure 1. Neutrophils induce EMT of tumor cells, leading to the dissemination from the primary tumor site; Mac-activated neutrophils increase vascular permeability and promote intravasation of tumor cells. Neutrophils and CTCs form CTC-neutrophil clusters mediated by VCAM-1, which escort CTCs. Neutrophil-secreted cytokines such as IL-8, IL-1β, MMP-8, MMP-9, and ROS weaken the endothelial barrier and promote extravasation. The Mac-1 expression on the surface of neutrophils interacts with the ICAM-1 expression of CTCs to enhance adhesion and extravasation of tumor cells. EMT: Epithelial-mesenchymal transformation; CTCs: circulating tumor cells; MAC: membrane attack complex; VCAM-1: vascular cell adhesion molecule-1; ICAM-1: intercellular adhesion molecule-1. Created in BioRender.com.