Although the multivariate Cox regression model demonstrated that lymphatic invasion (P < 0.001) and TNM stage (P = 0.017) were independent prognostic factors for PFS but not CTCs (Table 2), the Kaplan–Meier survival curves showed that CTCs-positive patients with advanced CRC had a significantly unfavorable OS (16.5 vs. 23 months, P = 0.0278) (Fig. 3b), and CTM-positive patients had worse OS than CTCs-positive patients (12 vs. 18 months, P = 0.0228) (Fig. 3d). The gene discussed is HSF4; the disease is colorectal carcinoma.