Abstract： AIM To develop a cell-surface vimentin (csVim) based circulating tumor cell (CTC) detection technique for identifying epithelial-mesenchymal transition (EMT)-like CTCs and investigating whether it can be used to assess tumor progression in esophageal squamous cell carcinoma (ESCC) patients.METHODS Immunofluorescence assay was used to analyze the expression and cell membrane translocation of csVim in KYSE510-PURα cell line and peripheral blood CTCs from ESCC patients.In this study,30 patients undergoing surgical therapy were recruited.The numbers of CTCs,EMT-like CTCs and white blood cells were counted.The correlation of different CTC subtypes with tumor progression was assessed in ESCC patients.RESULTS The expression of csVim was significantly increased in KYSE 510-PURα cells.CsVim was mainly located on the cell membrane,and it underwent cell membrane translocation.CTCs with the phenotype of CK8/18/19+,DAPI+ and CD45 were detected in 63.3％ (19/30) of patients.EMT-like CTCs with the phenotype of csVim+,CK8/18/19+,DAPI+ and CD45 were detected in 46.7％ (14/30) of patients,accounting for 73.7％ (14/19) of CTCs.Compared with ESCC patients without lymph node metastasis,the number of EMT-like CTCs in peripheral blood was higher in patients with lymph node metastasis (P =0.049).CONCLUSION CTCs in ESCC patients are highly heterogeneous.EMT-like CTCs are related to tumor progression and may be a potential biomarker for lymph node metastases in ESCC.The identification of EMT-like CTCs provides a new approach to estimate tumor progression and prognosis.