Additional similar studies proved that the expression of EpCAM+ CTCs in HCC patients showed a significant positive correlation to the serum AFP level (35), BCLC stage (38) and was associated with vascular invasion (40), disease progression (35), higher recurrence rate (33), and shorter disease-free survival (DFS) and overall survival (OS) (31). This evidence concerns the gene EPCAM and hepatocellular carcinoma.