Georgian Scientists/ . 7 N 1, 2025 50 Georgian Scientists Vol. 7 Issue 4, 2025 https://doi.org/10.52340/gs.2025.07.01.06 FOXP3+ : 1; 2; 3; 4 , , , . T (Tregs), FOXP3 , , . 1 (PDL1) , . FOXP3 PDL1- . 150 . FOXP3 PDL1 , , . , FOXP3 ( 22-30%) 5%). FOXP3 (30%), (22%). FOXP3 PDL1 (Spearman- = 0.75, p<0.001). , FOXP3 PDL1 (pT2) (pT1). FOXP3 PDL1 , . : FOXP3; PDL1; ; ; Georgian Scientists/ . 7 N 1, 2025 51 , , .[1] , . , , 2020 417,000 97,000 . , , .[2] , (5%- ), , 30%- . 80-85%- , , , , , 10%- . [3], [4] . . T (Tregs), FOXP3- (Forkhead Box P3) , . Tregs , . Tregs- . , . [4], [5] FOXP3 , Tregs- , . : , , . FOXP3+ Tregs , . .[6] Georgian Scientists/ . 7 N 1, 2025 52 , (ER) (PR). . ER PR FOXP3+ Tregs- , , . FOXP3 ER/PR . [7] 1 (PD-L1) , PD-1 T , T- . PD-L1 . FOXP3+ Tregs PD-L1 , . , .[7] FOXP3+ Tregs- PD-L1- , . . , , . , 2017-2025 . , , . : - 40 ; - 40 ; - 40 ; - 30 ; : , , . Georgian Scientists/ . 7 N 1, 2025 53 . ; : . . ( ., 18-45 46-55 ). , (FFPE) . 2-4 . (H&E) . (IHC): FOXP3 (abcam) PDL1 (Leica PD-L1 Clone: 73-10 Assay) Novolink Polymer Detection System. Leica- . IHC : . (pH 6.0) 20 . 3% 10 . 4°C- . , (HRP) 30 . 3,3'- (DAB) . : - , ( - PDL1 ); 150 , 80 70 , . . : 34.5 (n=65), 61.2 (n=85). Georgian Scientists/ . 7 N 1, 2025 54 70%- ( ), 30%- . 85%- 15%- . FOXP3 : FOXP3 ( 25%) 18%) (p<0.05). , . 3: FOXP3- ; ( ) ( ): ( , ) FOXP3 ( 5%) ( ), 22% 30% (p<0.001). FOXP3- Tregs- . Georgian Scientists/ . 7 N 1, 2025 55 2. A. FOXP3 , , IHC, 400X; B. FOXP3 , IHC, 400X; C. FOXP3 , IHC, 400X; D. FOXP3 IHC, 400X; E. FOXP3 IHC; 400X; F. FOXP3 IHC; 400X; Georgian Scientists/ . 7 N 1, 2025 56 4: FOXP3- ; PDL1 . PDL1 6%, - 12%. , PDL1 ( 2%) (p<0.01). FOXP3 PDL1 : FOXP3 ( 30%) ( 22%) (p<0.01). , , , , . PDL1 ( 12%) ( 6%) (p<0.05). , , . FOXP3 : FOXP3 (pT2) (pT1). FOXP3- pT1 15%, pT2 Georgian Scientists/ . 7 N 1, 2025 57 30%- (p<0.05). T . 5: FOXP3 ; PDL1 : FOXP3- , PDL1 pT2 ( 12%) pT1 ( 5%) (p<0.01). , PDL1 . FOXP3- PDL1- , 0,75 (p<0,001). (FOXP3- ) (PDL1- ) . Georgian Scientists/ . 7 N 1, 2025 58 6: FOXP3 PDL1 , , . (TILs) . TIL- FOXP3 : TIL- 10%, TIL- 25% (p<0.001). FOXP3 TIL- . TIL- ( ) FOXP3 , , TIL- Tregs- . Georgian Scientists/ . 7 N 1, 2025 59 7: TILs FOXP3 ; FOXP3 , T (Tregs) , . , FOXP3 , , . , , FOXP3- Tregs- (Zhou et al., 2019; Filaci et al., 2007) [8]. FOXP3 (30%), (Stewart et al., 2018). [9]Tregs- , . , FOXP3 (Sakaguchi et al., 2008)[10]. , FOXP3 , , , , (Fu et al., 2020).[11] Georgian Scientists/ . 7 N 1, 2025 60 FOXP3 PDL1 . , PDL1 (12%) (6%) (2%), , PDL1- (Topalian et al., 2015).[12] , FOXP3 PDL1 (Spearman- = 0.75, p<0.001) , Tregs (FOXP3- ) , , , . FOXP3- PDL1- , , (Gomez et al., 2019). [13] FOXP3 PDL1 , , . . , , . , FOXP3 (pT2) (pT1) (p<0.05). , FOXP3- (Nishikawa et al., 2008).[14] , Tregs- , . FOXP3- T- PDL1 . , FOXP3 , . , FOXP3 PDL1 , Georgian Scientists/ . 7 N 1, 2025 61 , Tregs- , PDL1- . T- PDL1 , . , FOXP3 PDL1 , . , T . , FOXP3, PDL1- , . [1] A. S. Uduwela, M. A. K. Perera, L. Aiqing, and I. S. 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Assessment of FOXP3+ Expression in Endometrial Precancerous and Neoplastic Lesions: A Comparative Study of Immune Microenvironment Dynamics Paata Zhorzholiani; Zaza Bokhua; Shota Kepuladze; Giorgi Burkadze Tbilisi State Medical University Abstract Background: Endometrial carcinoma is a leading cause of cancer-related mortality in women, with distinct subtypes such as endometrioid and serous carcinoma exhibiting varying clinical behaviours. Regulatory T cells (Tregs), marked by FOXP3 expression, play a crucial role in immune modulation within the tumour microenvironment. Programmed cell death ligand 1 (PDL1) is another key immune checkpoint molecule associated with immune evasion in various malignancies. This study investigates the expression of FOXP3 and PDL1 in benign and malignant endometrial lesions, comparing endometrial hyperplasias, endometrioid adenocarcinoma, and serous carcinoma. Methods: 150 cases were analysed, including 80 benign hyperplasias (with and without atypia) and 70 malignant lesions (endometrioid and serous carcinoma). FOXP3 and PDL1 expression levels were assessed using immunohistochemistry, and statistical analyses were performed to evaluate the Georgian Scientists/ . 7 N 1, 2025 63 correlation between these markers and clinicopathological features such as age, tumour stage, and histological subtype. Results: FOXP3 expression was significantly higher in malignant lesions (mean 22-30%) compared to benign hyperplasias (mean 5%). Serous carcinoma exhibited the highest FOXP3 expression (30%), followed by endometrioid carcinoma (22%). PDL1 expression was also significantly higher in malignant tumours, with serous carcinoma showing a mean expression of 12% compared to 6% in endometrioid carcinoma. A positive correlation between FOXP3 and PDL1 expression was observed (Spearman’s correlation coefficient = 0.75, p<0.001). Additionally, higher FOXP3 and PDL1 expressions were observed in advanced-stage tumours (pT2) compared to early-stage tumours (pT1). Conclusion: The study demonstrates that FOXP3-positive Tregs and PDL1 are significantly upregulated in malignant endometrial tumours, particularly in serous carcinoma, associated with a more aggressive clinical course. The positive correlation between FOXP3 and PDL1 expression suggests a potential mechanism of immune evasion and supports immune checkpoint inhibition as a therapeutic strategy in endometrial carcinoma. Keywords: FOXP3; Tregs; PDL1; Endometrial carcinoma; Serous carcinoma; - ; Paata Zhorzholiani – PhD Student at Tbilisi State Medical University Email: paatazhorzholiani00@gmail.com Phone Number: +995593593434 - ; Zaza Bokhua – Associate Professor at Tbilisi State Medical University Department of Obstetrics- Gynecology and Reproductive Health; Email: z.bokhua@tsmu.edu - ; ; Shota Kepuladze – Anatomical and Clinical Pathologist at Tbilisi State Medical University; PhD; Email: Shota.kepuladze@gmail.com Sh.kepuladze@tsmu.edu /Phone Number: +995558286170 Orcid: https://orcid.org/0000-0002-5919-5581 - , ; George Burkadze - Professor at Tbilisi State Medical University, Head of the Department of Molecular pathology; E-mail: burkadze@yahoo.com g.burkadze@tsmu.edu /Phone Number: 599578833 Orcid: https://orcid.org/0000-0002-5028-4537