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Single-cell whole-genome sequencing studies have demonstrated that even clonally related tumor cells can exhibit striking karyotypic diversity, with divergent chromosomal complements arising from a single mitotic division, generates a continuous supply of genetic variants for selection can act ( 2.4 Epigenetic heterogeneity and phenotypic plasticity While genetic alterations provide heritable diversity, epigenetic mechanisms enable rapid and reversible modulation of gene expression without changes to DNA sequence

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