EPCAM and metastatic carcinoma: In that study and subsequent studies [7,9,10], we observed that elevated levels of circulating large tdEVs, defined here as particles of a size between 1 and 12 μm that co-express epithelial cell adhesion molecule (EpCAM) and cytokeratin (CK) but lack leukocyte-specific CD45 and nuclear staining, were detected in nearly 75% of patients with different metastatic carcinomas.