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. 2025 Aug 19;17(16):2691.
doi: 10.3390/cancers17162691.

A Comparison of the Flow Cytometric Analysis Results of Benign and Malignant Serous Tumors of the Ovary

Ozgur Ozdemir  1 , Mustafa Emre Duygulu  2 , Yavuz Tekelioglu  3 , Safak Ersoz  4 , Suleyman Guven  5
Affiliations

A Comparison of the Flow Cytometric Analysis Results of Benign and Malignant Serous Tumors of the Ovary

Ozgur Ozdemir et al. Cancers (Basel). .

Abstract

Background/Objectives: Flow cytometric analysis of cellular DNA content has prognostic importance in ovarian cancer and its measurement could contribute to clinical practice. The aim of this study was to compare serous cystadenoma and serous cystadenocarcinoma cases in terms of their flow cytometric analysis results. Methods: In total, 60 serous ovarian tumor cases (30 cases of ovarian serous cyst adenoma and 30 cases of ovarian serous cystadenocarcinoma) in paraffin blocks were extracted from hospital pathology archives for flow cytometric analysis. Cell cycle changes, aneuploidy ratio, and annexin V levels were compared. Results: The S phase cell ratio, proliferative index, aneuploidy cell ratio, and annexin V apoptotic index were significantly higher in the cancer group compared to the cystadenoma group. However, the G2/M phase cell ratio was found to be similar in both groups. When the annexin V apoptotic index cutoff value was selected as 27.65%, the sensitivity was calculated as 90.0% and the specificity as 93.3% for predicting serous ovarian carcinoma (AUC, 0.872; p < 0.001; 95% CI, 0.761-0.984). Conclusions: In serous cystadenocarcinoma cases, cell cycle activity was increased compared to serous cyst adenoma, but the similarity of G2/M activities suggested that serous cystadenocarcinoma may be a member of the "metaneoplasia" process. The detection of annexin V expression in ovarian tumors by flow cytometric analysis is a cheap, fast, and easy diagnostic method that can be used in the diagnosis of ovarian cancer. Annexin V expression is an effective biomarker with high sensitivity and specificity that could be used in the diagnosis of serous ovarian cancer.

Keywords: annexin V; flow cytometry; ovarian cancer; serous tumor.

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Conflict of interest statement

Author Ozdemir O was employed by her own company, Ozgur Ozdemir Co. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Sample flow cytometric analysis results for the aneuploidy cell ratio in a case of serous cystadenoma.
Figure 2
Figure 2
Sample flow cytometric analysis results for the aneuploidy cell ratio in a case of serous cystadenocarcinoma.
Figure 3
Figure 3
Sample flow cytometric analysis results for annexin V apoptotic index in cases of serous cystadenoma (a) and serous cystadenocarcinoma (b).
Figure 4
Figure 4
ROC analysis of the annexin V apoptotic index in terms of predicting serous ovarian carcinoma.
See this image and copyright information in PMC

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