Objective To explore the clinical manifestations,pathological features,treatment,and prognosis of cervical cancer containing invasive stratified mucin producing carcinoma(ISMC)components.Methods A retrospective analysis was conducted on the clinical and pathological data of 6 cases of ISMC or cervical adenocarcinoma containing ISMC components diagnosed by the pathology department of Xiamen University Affiliated First Hospital from January 2021 to June 2023.Results Six patients with pathological diagnosis of ISMC or cervical adenocarcinoma containing ISMC components,aged 45～61 years,presented with irregular vaginal bleeding,abnormal vaginal discharge,or cervical lesions as the main clinical manifestations.Under the microscope,tumor cells are mostly in the form of nests or patches arranged in an infiltrative manner.The number of microcapsules inside the epithelial nests varies,and the cysts contain a large amount of neutrophils,necrotic cells,or mucus;Some tumor cells contain mucus in their cytoplasm,with mild to moderate cellular atypia.The cells surrounding the nest are arranged in a basal cell like palisade pattern;visible small nucleoli,mitotic bodies,and apoptotic bodies.Cells have no keratinization or intercellular bridging.Immunohistochemistry showed strong diffuse expression of p16 and CK7(+),focal expression of CEA,CK5/6,P63,and PAX-8(+),Ki-67 proliferation index ranging from 25％to 80％,and ER and PR(-).Sheff's and Alcian blue histological staining showed that the cytoplasm was rich in mucus.Among them,5 patients were detected with high-risk HPV,while the remaining 1 did not undergo the test.No cases of tumor recurrence or metastasis were found during follow-up.Conclusion ISMC is a rare cervical invasive adenocarcinoma with characteristic pathological changes,associated with high-risk HPV infection,and prone to misdiagnosis and missed diagnosis.Understanding the unique pathological features and immunophenotypes of ISMC is helpful for pathological diagnosis and clinical treatment.
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