Page 29 - TD-4-1

Tumor Discovery Immunohistochemistry profiling of ovarian cysts

AXL receptor: AXL receptor is a member of the tyrosine for definitive diagnosis. AI and ML offer the advantage
kinases family of receptors, known to promote cell survival of reducing false-positive and false-negative results.
and inhibit apoptosis, thereby playing a significant role in Integrating ICC with molecular diagnostics and AI could
ovarian cancer progression. AXL is often overexpressed enhance diagnostic precision. Further studies have
88
in ovarian cancer cells, making it a biomarker of interest. explored the combination of the ICC method with other
Its positive regulation is associated with tumor metastasis, diagnostic techniques such as CT, ultrasound, and MRI.
89
aggressiveness, and resistance to conventional therapies. A conducted by van den Brule et al. revealed that the
Activation of AXL signaling pathways can lead to epithelial- combination of ICC and ultrasound yielded a sensitivity
to-mesenchymal transition, facilitating cancer cell of 98% and specificity of 96% in diagnosing malignant
invasion. In addition, AXL can evade antitumor immune ovarian cysts. Similarly, Lee et al. discovered that the
36
response, contributing to its role in cancer progression. 80,81 combination of ICC and MRI yielded a sensitivity of
CA72-4: CA72-4 is a tumor-related glycoprotein and 97% and specificity of 95% in the diagnosis of malignant
a specific epitope on MUC1. An unusual increment of ovarian cysts.
CA72-4 has been reported in ovarian cancer, although the Future directions focus on multiplex ICC for
levels are not affected by menstrual cycle, pregnancy, and simultaneous detection of multiple markers and digital
endometriosis, but are slightly affected by inflammatory pathology for enhanced accurate results and consistent
conditions. This stability suggests that CA720-4 could interpretations, 90,91 Novel biomarkers, such as YKL-40
serve as a potential diagnostic marker for ovarian cancer. and mesothelin, are being investigated for their potential
Moreover, a study detected overexpression of CA72-4 in to improve ovarian cancer diagnosis and prognosis.
mucinous tumors and clear ovarian cell carcinomas, while Researchers are also working towards improving the
CA125 and HE4 levels were not elevated in those two standardization of ICC practice and existing techniques. 92,93
histotypes. 82 12. Conclusion
The 21 century is witnessing emerging ICC biomarkers
st
for ovarian cysts. They include Ki-67, p53, and WT1. ICC has emerged as a critical diagnostic tool for
83
Studies have shown that ICC biomarkers, such as CA-125 distinguishing between benign and malignant ovarian
and Ki-67, are frequently used to detect benign ovarian lesions. The use of a panel of antibodies targeting specific
lesions. CA-125 is said to be elevated in benign ovarian biomarkers (antigens) associated with benign and
cysts such as endometriosis and cystadenomas. Ki-67 is malignant ovarian cysts provides a high level of sensitivity
associated with cellular proliferation. Benign cystic lesions and specificity compared to traditional diagnostic
84
typically show low expression of malignant biomarkers. techniques. ICC significantly enhances the diagnostic
85
Malignant ovarian lesions often express p53, HE4, and accuracy of ovarian cysts, providing a distinction between
WT1. p53 mutations are particularly associated with high- benign from malignant lesions with greater precision than
grade serous carcinomas, while HE4 and WTI are specific traditional methods. Key biomarkers such as CA-125, HE4,
86
to ovarian malignancies. A study has demonstrated that p53, and Ki-67 play critical roles in this distinction. Despite
a combination of CA-125 and HE4 enhanced diagnostic its strength, ICC poses several limitations. However,
accuracy for ovarian cancer. 87 the combination of ICC with other advanced diagnostic
methods holds the potential to enhance the diagnosis and
11. Current state of research and future management of ovarian cysts, leading to improvement in
directions patient outcomes. Ongoing research is aimed at improving
protocol standardization, discovering novel markers,
The application of ICC in ovarian cyst diagnosis is a exploring multiplex marker panels, and integrating ICC
rapidly evolving method, with ongoing research aimed at with other diagnostic methods.
improving diagnostic accuracy and consistency. A critical
area of concern is the development of standardized Acknowledgments
antibody panels for use across laboratories. Artificial None.
intelligence (AI) and machine learning (ML) algorithms
are emerging fields of research that aim to improve Funding
the interpretation of results and enhance objectivity
and consistency. AI algorithms can analyze complex None.
signaling and imaging data, enabling early detection and Conflict of interest
characterization of ovarian cysts, by recognizing unique
patterns and identifying easily missed features, allowing The authors declare that they have no competing interests.

Volume 4 Issue 1 (2025) 21 doi: 10.36922/td.5369