Expressions of PD-L1 and FOXP3 in uterine cervical neoplasms may indicate tumor invasion and squamous differentiation

Objectives: Increasing evidence has demonstrated that upregulation of programmed death cell ligand-1 (PD-L1) and FOXP3-positive regulatory T cells in different malignancies plays a critical role in tumor progression. In the present study, the evaluation of PD-L1 and FOXP3 tissue expressions in a spectrum of cervical neoplasms were performed. Material and method: Immunohistochemical PD-L1 and FOXP3 expressions were evaluated in a total of 107 formalin-fixed, paraffin-embedded uterine cervical neoplasm specimens, and their association with some pathological parameters was tried to be elucidated. Results: Cases with low or high squamous intraepithelial lesion (n = 59), squamous cell carcinoma (n = 27), adenosquamous carcinoma (n = 15) and adenocarcinoma (n = 6) were included in this study. Tumoral PD-L1 was detected in most squamous cell carcinomas while it was found in almost none of the intraepithelial lesions (p $<$ 0.001). Similarly, the number of both PD-L1, and FOXP3-positive inflammatory cells was statistically significantly higher in invasive tumors than in intraepithelial lesions (p < 0.001). Conclusion: Our findings demonstrated the association between the histological types of uterine neoplasms and PD-L1 or FOXP expressions, as well as the correlation between presence of invasion and tumoral PD-L1 expression. Therefore, it may be suggested that PD-L1 plays an important role in the pathogenesis of cervical neoplasms.

Uterus; Cervical carcinomas; Squamous intraepithelial lesions; PD-L1; FOXP3

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