Circulating tumor cells (CTCs) have the potential to provide a surrogate for "real-time biopsy" of tumor biological activity. Enumeration and molecular characterization of CTCs in pancreatic cancer could play an important role in diagnosis, predicting the risk for tumor recurrence, and providing novel target therapy biomarkers. CTCs can disseminate into peripheral blood in the preinvasive and early stages of pancreatic cancer. In view of these facts, we propose that identification and molecular analysis of the malignant characteristics of CTCs may serve as a "liquid biopsy" in pancreatic cancer for early diagnosis.
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