Objectives: High-grade serous carcinoma (HGSC) is recognized as the most aggressive form of ovarian
cancer (OC), with frequent recurrence despite treatment. Recently, the CT45 gene has emerged as a
potential player in OC prognosis, with studies indicating its association with extended disease-free
survival. This investigation aims to assess CT45 expression at both mRNA and protein levels in relation to
recurrence and disease-free survival in OC patients undergoing different treatment modalities.
Materials & Methods: Fifty-eight confirmed HGSC cases were included in this study, with tissue samples
collected intraoperatively for mRNA and protein expression analysis. mRNA expression was assessed via
quantitative PCR (qPCR), while protein expression was evaluated through immunohistochemistry (IHC).
Blood samples were also collected preoperatively for serum CT45 quantification using enzyme-linked
immunosorbent assay (ELISA). CT45 sera was only positive for ca ovary cases. Healthy control showed no
values. (p value 0.016). Patients were categorized into two groups based on treatment strategy: Group A
underwent upfront surgery followed by chemotherapy, while Group B received neoadjuvant
chemotherapy (NACT) followed by surgery and additional chemotherapy cycles.
Results: Analysis revealed that Group A exhibited significantly higher mRNA expression (75%) of CT45
compared to Group B, suggesting its potential as a prognostic indicator post-treatment. Notably,
patients with higher CT45 expression demonstrated lower rates of recurrence across both groups. Mean
of log 2-fold change of recurrent cases was 0.42 and non-recurrent cases was 3.42. Furthermore, higher
CT45 expression was associated with improved 5-year overall survival and progression-free survival.
Immunohistochemistry findings corroborated these results, with most cases (15%) showing minimal to
no CT45 expression (85% cases). Serum CT45 levels were elevated in recurrent cases compared to non-
recurrent cases, indicating a potential role as a biomarker for recurrence. (P-value 0.017)
Conclusions: CT45 emerges as a promising prognostic marker for disease-free survival in OC patients,
with higher mRNA expression correlating with reduced recurrence rates and improved survival
outcomes. Despite its modest sensitivity as a recurrence marker (56%) CT45 demonstrates high
specificity (66%) and holds promise as a biomarker for OC recurrence. As a diagnostic biomarker the sn
and sp is 73.08% and 98% respectively. However, discrepancies between mRNA expression and serum
levels suggest potential epigenetic variations that warrant further investigation with larger cohorts.