Pan-Kla signals activate transcription start site (TSS)-proximal regions of MYCN; this is a key transcription factor that promotes the neuroendocrine differentiation of PCa, and histone lactylation can activate the significant enrichment of neuroendocrine genes, such as Neural Cell Adhesion Molecule 1 (NCAM1) and Enolase 2 (ENO2). Here, NCAM1 is linked to posterior cortical atrophy.