Extracellular signals that induce EMT in tumor cells, such as tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), hepatocyte growth factor (HGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), mitogenic growth factor (MGF), vascular endothelial growth factor (VEGF), IL-6, IL-1β, Etc., which act on EMT-related transcription factors through activation of TGF-β, Wnt-β-catenin, Notch, Hedgehog, PI3K-AKT, NF-κB, MAPK, and other signaling pathways, leading to down-regulation of epithelial cell markers and up-regulation of mesenchymal cell markers (18). Here, TNF is linked to neoplasm.