Cancer continues to remain a "Black Box," as there is no consensus on how it initiates, progresses, metastasizes, or recurs. Many imponderables exist about whether somatic mutations initiate cancer, do cancer stem cells (CSCs) exist, and if yes, are they a result of de-differentiation or originate from tissue-resident stem cells; why do cancer cells express embryonic markers, and what leads to metastasis and recurrence. Currently, the detection of multiple solid cancers through liquid biopsy is based on circulating tumor cells (CTCs) or clusters, or circulating tumor DNA (ctDNA). However, quantity of starting material is usually adequate only when the tumor has grown beyond a certain size. We posit that pluripotent, endogenous, tissue-resident, very small embryonic-like stem cells (VSELs) that exist in small numbers in all adult tissues, exit from their quiescent state due to epigenetic changes in response to various insults and transform into CSCs to initiate cancer. VSELs and CSCs share properties like quiescence, pluripotency, self-renewal, immortality, plasticity, enrichment in side-population, mobilization, and resistance to oncotherapy. HrC test, developed by Epigeneres, offers the potential for early detection of cancer using a common set of VSEL/CSC specific bio-markers in peripheral blood. In addition, NGS studies on VSELs/CSCs/tissue-specific progenitors using the All Organ Biopsy (AOB) test provide exomic and transcriptomic information regarding impacted organ(s), cancer type/subtype, germline/somatic mutations, altered gene expressions, and dysregulated pathways. To conclude, HrC and AOB tests can confirm the absence of cancer and categorize the rest of subjects into low/moderate/high risk of cancer, and also monitor response to therapy, remission, and recurrence.

中文翻译：

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非常小的胚胎样干细胞转化为癌症干细胞，是通过简单的血液测试检测/监测癌症的新候选者。

癌症仍然是一个“黑匣子”，因为对于它如何开始、进展、转移或复发还没有达成共识。关于体细胞突变是否引发癌症、是否存在癌症干细胞 (CSC)，以及如果存在，它们是去分化的结果还是源自组织驻留干细胞，存在许多不可估量的问题；为什么癌细胞会表达胚胎标志物，以及是什么导致转移和复发。目前，通过液体活检检测多种实体癌是基于循环肿瘤细胞（CTCs）或簇，或循环肿瘤DNA（ctDNA）。然而，通常只有当肿瘤生长超过一定大小时，起始材料的量才足够。我们假设多能性、内源性、组织驻留、非常小的胚胎样干细胞 (VSEL) 在所有成人组织中都存在少量，由于响应各种侮辱的表观遗传变化而退出静止状态，并转化为 CSC 以引发癌症。VSEL​​ 和 CSC 具有静止、多能性、自我更新、永生、可塑性、侧群富集、动员和抗肿瘤治疗等特性。由 Epigeneres 开发的 HrC 测试提供了使用外周血中一组通用的 VSEL/CSC 特异性生物标记物早期检测癌症的潜力。此外，使用全器官活检 (AOB) 测试对 VSEL/CSC/组织特异性祖细胞进行的 NGS 研究提供了关于受影响器官、癌症类型/亚型、种系/体细胞突变、改变的基因表达和以及失调的途径。总而言之，