Ultrasound-Responsive Serotonylation and Hallmark Pathway Gene Signatures Reveal Tumor Microenvironment Vulnerabilities and Prognostic Subtypes in Colorectal Cancer

This multiomics integration reveals a serotonylation-hallmark gene signature that represents microenvironmental characteristics, such as matrix stiffness, stromal density, and immune infiltration, that are pertinent to ultrasound-based CRC therapy. These biomarkers could direct patient classification for radiopharmaceutical, immunotherapy, and ultrasound-enhanced medication delivery. This work supports future clinical trial stratification frameworks and offers a mechanistic basis for precision ultrasound oncology.