Contrarily, the functions of shared mutations carried by CTCs were frequently enriched to cancer genes of regulation of RTK/RAS signaling; cell cycle and apoptosis; and TGFβ signaling pathways, particularly related to stem cell features, such as SHKBP1 in P2, PON1 in P7, and ORC1 in P9 as well as NUMA1, ZNF143 and MUC16 of P4, PELP1 of P5, and possibly ELP3 and BPTF of P6 (Table 2), indicating the difference of intrinsic or acquired resistance between metastatic lymph nodes and CTCs in drug-resistant patients. This evidence concerns the gene ELP3 and cancer.