Multi-Omics Analysis Delineates Molecular Signatures of Spinal Ependymal Tumor

Spinal ependymal tumors are a diverse group of neoplasms encompassing three subtypes: spinal ependymoma (SP-EPN), spinal myxopapillary ependymoma (SP-MPE), and spinal subependymoma (SP-SE). However, the molecular differences among these subtypes remain largely unknown. Here, we identified the distinct molecular characteristics of each subtype through a multi-omics analysis. In grade-2 SP-EPN, abnormal enrichment of ciliary signaling, particularly involving the MKS complex and Hedgehog (Hh) pathway, was evident, suggesting potential therapeutic targets. SP-MPE exhibited significant dysregulation of mitochondrial metabolism, reflecting a metabolic profile aligned with the Warburg effect. SP-SE tumors showed enhanced activity of immune-related pathways, including interferon signaling and extracellular vesicle dynamics, suggesting a distinct tumor microenvironment. This study underscores the molecular diversity of spinal ependymal tumors, offering novel insights into their pathobiology, and highlighting promising therapeutic avenues tailored to each subtype.