Mesenchymal Tissue-Driven Gene Programs Identify EMP3 as a Key Biomarker of Aggressiveness in Undifferentiated Sarcomas

Undifferentiated sarcomas (USs), including undifferentiated pleomorphic sarcoma (UPS), are aggressive mesenchymal malignancies with limited molecular biomarkers for prognostic assessment and therapeutic stratification. Expression-based markers may provide insight into tumor aggressiveness and clinical outcomes. Here, we performed integrative transcriptomic and spatial analyses to identify differentially expressed genes (DEGs). By comparing normal tissues with sarcoma tumors and sarcoma tumors with cell lines. Intersection and clustering analyses were conducted to define shared expression programs, which revealed a subset of DEGs enriched in epithelial-mesenchymal transition (EMT)-related pathways. CosMx spatial transcriptomics was applied to xenograft tumors derived from two UPS cell lines to resolve tumor-intrinsic signatures. The National Cancer Center Cohort samples were used for validation, and immunohistochemistry confirmed the expression in thirty US tissues. Spatial transcriptomic profiling identified mesenchymal tissue-driven gene expression programs in UPS xenografts. Across bulk RNA-seq and spatial data, epithelial membrane protein 3 (EMP3) consistently emerged as highly expressed in US tissues and cell lines. EMP3 is a robust mesenchymal-associated biomarker linked to EMT, tumor progression, and clinical outcomes in USs, supporting its potential utility as a prognostic indicator and therapeutic target.