Immunocytochemistry profiling of ovarian cysts: A review of its clinical utility, future direction, and challenges

Abstract

Ovarian cysts are fluid-filled sacs located in or on the surface of the ovaries. They can affect women of all ages but are most commonly seen in those of reproductive age and postmenopausal women. The two primary types of ovarian cysts are functional and pathological. Due to their asymptomatic nature, ovarian cysts are frequently diagnosed at later stages, potentially limiting therapeutic options and negatively affecting patient outcomes. Early detection requires diagnostic modalities that can differentiate between benign and malignant ovarian lesions. One promising approach is the use of immunocytochemistry (ICC) in the diagnosis of ovarian cysts, a rapidly evolving method in ovarian pathology. ICC utilizes antibodies to detect and visualize specific cellular antigens (proteins) in cytology specimens, serving as an ancillary diagnostic technique for establishing empirical diagnoses, predicting biomarkers, and assessing prognosis. A standard ICC protocol entails sample preparation, fixation, permeabilization, blocking, immunolabeling, counter-staining, and microscopic imaging of stained cells. Specific biomarkers play a significant role in distinguishing between benign and malignant ovarian cysts. Commonly used biomarkers include Cancer antigen 125, Ki-67, p53, HE4, and WT1. Future directions in this field are likely to focus on multiplex ICC, the discovery of novel biomarkers, the integration of artificial intelligence with other diagnostic modalities, and improving the standardization of ICC practice. Integrating these biomarkers into ovarian pathology will enable accurate diagnosis with reduced turnaround times, overcoming the limitations of hematoxylin and eosin staining methods.

Keywords

Immunocytochemistry / Profiling / Ovarian cyst / Review

Funding

None.

Conflict of interest

The authors declare that they have no competing interests.

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