Development of a 23-Gene Signature for Tumor Growth Mechanism in Vestibular Schwannoma

Background/Objectives: Transcriptome profiling can reveal prognostic biomarkers and therapeutic vulnerabilities for directing clinical care. Currently, there are no biomarkers that can accurately predict patient prognosis regarding tumor growth and the tumor immune microenvironment in vestibular schwannomas. This study aimed to investigate the mechanisms of tumor growth using bulk RNA-seq and single-cell data from patients with vestibular schwannomas. Methods: Gene set variation analysis was used to assess groups with high and low tumor growth using four cohorts of bulk RNA-seq data (210 patients with vestibular schwannoma), 33,081 single cells, and 558 tumor growth-related genes. Results: SIG558, a tumor growth signature gene, was enriched in Schwann cells and microglial cells with high stemness, according to stemness analysis and cell-cell communication analysis of 33,081 single cells. We identified 391 genes that were strongly expressed in Schwann cells with high stemness. In addition, we identified 23 genes related to signal transduction that are important for tumor growth through cell-cell interactions in seven cell types at the single-cell level. Conclusions: Our research demonstrates that the 23 signature genes are potential predictors and prognostic biomarkers for direct medical therapy in patients with vestibular schwannoma, and that they should be prospectively verified using large patient cohorts. These results could potentially be used in precision medicine to develop treatment strategies for vestibular schwannomas by targeting these 23 genes.