## 3 Results  
The proposed study aims to analyze the effects of cisplatin (a chemotherapy drug) [53] and exosomes derived from mesenchymal stem cells, which have a reparative effect [54], on the female ovaries of cancer patients. In this study, we have five groups: Cis (cisplatin-treated groups), Exo (exosome-treated groups), ExoCis (groups treated with exosome followed by cisplatin), CisExo (groups treated with cisplatin followed by exosome) and Control (healthy groups). According to the information obtained from pathology experts [55], it is known that the exosome treatment group for cancer patients has a reparative effect [54] and its results  
Figure 4: Confusion matrix. are close to the Control group. A noticeable difference is observed between the Control group and the cisplatin-treated cancer patients. Based on this information provided by experts, to present more definitive results regarding the comparisons between groups, the results were analyzed by classifying them using machine learning methods such as ANN, SVM, KNN, and DT. The classification was performed by creating groups between the Control group and the Cisplatin and Exosome groups, as shown in Figure 5.  
During the study, 59 LBP features were extracted from each of the RGB (Red, Green, Blue) channels for the images in each group, resulting in a total of 177 features per image. Despite the complexity and limited distinctiveness of other features, LBP was chosen for this study due to its ability to represent tissue differences quickly, efficiently, and with high accuracy [56]. The distribution of the mean LBP features for each group is illustrated in Figure 6 using a violin plot. Lower LBP values indicate a more homogeneous tissue structure, whereas higher values reflect increased heterogeneity. In the graph, the CisExo group exhibits a narrow distribution, indicating that its features are concentrated within a specific range and show low variance. This suggests that the CisExo group has a more homogeneous texture. In contrast, the ExoCis group displays a broader distribution compared to the other groups, with higher intensity at the extremes, indicating greater variability in feature values. This broad distribution suggests that the ExoCis group may possess a more heterogeneous texture. The Control group, on the other hand, exhibits a moderately wide distribution, with most features concentrated around a central value and less spread toward the extremes. This indicates that the Control group has a moderately homogeneous structure. In conclusion, the LBP features reveal that the CisExo group has the most homogeneous structure, while the ExoCis group shows the highest heterogeneity and variability. The observation that the ExoCis group is more heterogeneous than the CisExo group but closer to the Control group suggests fewer pronounced pathological changes. These findings indicate that the ExoCis group may have undergone a better recovery process compared to the CisExo group. The extracted LBP features were analyzed using statistical methods. However, due to the large number of features (177 in total), the results were not included in the manuscript but were provided as a Supplementary File. A normality test was performed for all features; however, as none of the features followed a normal distribution, the Kruskal-Wallis test was applied to all of them. For features that showed significant differences among groups, a post hoc analysis (Dunn test) was performed to identify which groups (Cis, Exo, CisExo, ExoCis, and Control) differed significantly. As a result, 51 features were found to exhibit significant differences, and post hoc analysis revealed significant differences specifically between the CisExo-Cis and CisExo-Exo groups. Please refer to the Supplementary File for detailed statistical test results (\(p\)-values). The statistical test analyses were performed using the R statistical software (R-4.4.2 version). Unique features for each feature set were selected from the extracted features.