Recently, Cheng et al. [65] found that in GC patients with negative PD-L1 in tumor tissue, the CTC Imaging flow cytometry signal was as varied as that of IHC staining, suggesting that expression of CTC PD-L1 is useful in the immunophenotypic differential diagnosis of tumors and thus can be a potential candidate for anti-PD-1/PD-L1 immune checkpoint therapy [98]. This evidence concerns the gene CD274 and gastric cancer.