Ovarian cancer is the most lethal gynecologic malignancy. In 2020, it caused 207,252 deaths worldwide, and there were more than 324,603 new cases of ovarian cancer in 2022. Thus, considerable efforts are ongoing to develop screening and diagnostic methods, and novel therapies for ovarian cancer [1], [2].

The Tricho-rhino-phalangeal Syndrome 1 (TRPS1) gene protein, also termed Transcriptional Repressor GATA Binding 1, is an atypical GATA (Guanine-Adenine-Thymine-Adenine-binding protein) nuclear transcription factor protein encoded by the TRPS1 gene on chromosome 8q23–24. It acts as a transcriptional repressor that can prevent the expression of GATA 1–6-regulated genes [3], [4].

TRPS1 gene was originally identified in 3 rare autosomal-dominant syndromes characterized by craniofacial and skeletal abnormalities caused by loss-of-function alterations [4]. During development, TRPS1 regulates several major cellular processes. It is reported to regulate bone, kidney, and hair development, and serve to modulate chondrocyte proliferation and apoptosis by interaction with several signaling molecules. However, high TRPS1 expression occurs in normal adult prostate, ovary, kidney, and breast tissues [3].

In pathological conditions, TRPS1 participates in obesity-related metabolic diseases and is altered or overexpressed in multiple cancers, being associated with tumor cell proliferation, invasion, migration, metastasis, and multidrug-resistance; thus, it seems to be involved in both tumorigenesis and prognosis of cancers [3], [5]. The highest rate of TRPS1 positivity was found in various types of breast cancer (51.4 to 100%). Therefore, several studies suggested that TRPS1 is a highly sensitive and specific marker for breast carcinoma that can be used as a powerful diagnostic tool, especially for triple-negative breast carcinoma (TNBC) [6], [7], [8]. Others considered TRPS1 as a new promising marker for assessment of distant metastatic breast cancer in pleural effusion cytology and in surgical tissue samples as well [9], [10]. Meanwhile, TRPS1 was detected in other cancers, such as soft tissue tumors (up to 100%), salivary gland tumors (up to 46.2%), squamous cell carcinomas of various sites (up to 34.7%), and diverse gynecological cancers (up to 40%) [3], [11], [12].

From clinical perspective, detection of TRPS1 would not only gain novel insights into the complex etiology of diseases but also provide the fundamental basis for the development of therapeutic drugs targeting both TRPS1 and its critical cofactors, facilitating individualized treatment [3].

In a recent study by Wang et al. [12], TRPS1 was highly-expressed in high-grade serous carcinoma (HGSC) of the ovary compared to normal ovarian tissues. It was also linked to the cell proliferation index Ki-67 and to survival. However, it was not expressed in clear cell carcinoma (CCC) [8], indicating that TRPS1 might be differentially-expressed across different subtypes of epithelial ovarian cancers (EOCs). To our knowledge, very few studies have investigated TRPS1 expression in EOCs [8], [12], and the diagnostic or prognostic role of TRPS1 protein expression in other subtypes of EOCs is still unexplored [11].