expression of galectin-9 and ctla-4 as potential biomarkers in ovarian cancer: their association with histological subtypes and disease stage

Ovarian cancer is the second leading cause of gynecologic cancer-related deaths worldwide, with its high mortality rate largely attributed to late-stage detection and tumor heterogeneity. recent evidence suggests that immune-related biomarkers, including galectin-9 and ctla-4, play a critical role in cancer progression and may serve as potential prognostic and therapeutic targets. this research investigated the expression levels of galectin-9 and ctla-4 in high-grade serous ovarian cancer (hgsoc) and low-grade serous ovarian cancer (lgsoc), exploring their correlation with tumor stage and ca 125 levels. a retrospective cross-sectional study was conducted on ovarian cancer patients at dr. soetomo general hospital, surabaya, from 2021 to 2023. immunohistochemical analysis was performed on 50 paraffin-embedded tissue samples to assess biomarker expression. chi-square statistical analysis identified a significant difference in galectin-9 expression between hgsoc and lgsoc (p = 0.0485). similarly, ctla-4 expression showed a highly significant difference between these subtypes (p = 0.0000021). furthermore, a significant association was observed between ctla-4 expression and tumor stage (p = 0.000229), suggesting its role in disease progression. however, no notable association was identified between the expression of either biomarker and ca 125 levels. these findings suggest that galectin-9 and ctla-4 may serve as valuable biomarkers for distinguishing ovarian cancer subtypes and assessing disease progression, particularly in hgsoc. further large-scale studies and functional analyses are warranted to explore their potential roles in prognosis and response to immunotherapy.