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Article History

Received: 23 July 2025

Accepted: 9 January 2026

First Online: 2 February 2026

Declarations

:

: This study was approved by the institutional review boards or ethics committees at each participating institution, including the University of Alabama at Birmingham (IRB no. F160906009), Stanford University (IRB no. 39264), Hangzhou Women’s Hospital (IRB no. 2021–01-003), and Shenzhen Maternity and Child Health Hospital (IRB no. 2021–09-001). All participants were enrolled under IRB-approved protocols at their respective study sites, and written informed consent was obtained from all participants prior to sample collection. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki, and all clinical data were de-identified prior to analysis.

: Not applicable.

: CJC, NG, BJ, KJS, RDM, and JS are employees of OncoOmicDx Clinical Laboratory, Maryland, U.S.. However, the company had no role in the design of the study, data collection, data analysis, interpretation, or preparation of this manuscript. All research and experimental work were conducted independently, and no external influence impacted the study’s findings or conclusions. The authors associated with hospitals and universities declare no competing interest.