Neurodegeneration Promotes Tumorigenesis in Colorectal Cancer: Insights From Single-Cell and Spatial Multiomics

PURPOSE Colorectal cancer (CRC) ranks third in global incidence and second in mortality, with rates increasing among younger populations. The enteric nervous system (ENS) is crucial for gastrointestinal function, and its dysfunction is associated with the progression of CRC. Neurodegeneration may disrupt ENS function and facilitate tumor growth although the mechanisms remain unclear. METHODS AND MATERIALS This study integrated single-nucleus, single-cell RNA sequencing, spatial transcriptomics (ST), and bulk transcriptomics data. Summary data-based Mendelian randomization (SMR) analysis identified neurodegeneration-related genes associated with CRC progression. Cell-cell communication was analyzed using CellCall and Cytotalk, and trajectory analysis performed using VECTOR. ST analysis was conducted using robust cell type decomposition, and spatial dependencies were assessed through MISTy and cell neighborhood network analyses. A deep learning–based prognostic model was developed using DeepSurv. Multiplex immunofluorescence was used to validate the functions of cells. RESULTS SMR analysis identified seven neurodegeneration-related genes, including MAPK9 , associated with the development of CRC. High-neurodegeneration neurons were associated with poorer prognoses and infiltrated deeper into tumor niches. MISTy analysis revealed stronger spatial dependencies between high-neurodegeneration neurons and epithelial cells. Homotypic and heterotypic cell neighborhood network analyses revealed tighter neuron networks in high-degeneration groups, with enhanced neuron-epithelial communication. MAPK9 -positive neurons were highly expressed in sensory neurons and facilitated tumor growth via EGFR signaling. The DeepSurv model demonstrated strong prognostic performance, with high-risk patients exhibiting worse outcomes and elevated expression of immune checkpoint genes. CONCLUSION Neurodegeneration, particularly involving MAPK9 -positive neurons, promotes CRC progression through enhanced neuron-tumor interactions and EGFR signaling. This study underscores the significance of targeting neurodegeneration in CRC treatment.