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Archive > Volume 32 Issue 3 > 2025,32(3):301-308. DOI:10.3872/j.issn.1007-385X.2025.03.010 Prev Next
Clinical Research
Stratified mucin-producing epithelial neoplastic lesions of the cervix: clinicohistologic and molecular pathological characteristics
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Abstract:
[Abstract] Objective: To investigate the clinicohistologic and molecular pathological characteristics of invasive stratified mucin producing carcinoma (ISMC). Methods: The clinicopathological data, immunohistochemistry, alcian blue/periodic acid-Schiff (AB/ PAS) staining, molecular detection and PD-L1 expressions of 11 cases of ISMC and 4 cases of stratified mucin-producing intraepithelial lesion (SMILE) in the pathological database of Anqing Medical Center of Anhui Medical University /Anqing Municipal Hospital and the first Affiliated hospital of Wannan Medical School/Yijishan Hostital between January of 2018 and March of 2024 were retrospectively analyzed. Results: ISMC patients often presented with irregular vaginal bleeding. Morphologically, the cells containing mucus in the cytoplasm were arranged in stratified layers, surrounded by a palisade, and the tumor cells might be signet ring-shaped or have clear cytoplasm. ISMC might occur in both pure and mixed forms. ISMC had highly invasive biological characteristics. CK7, p16, p40 and (or) p63 were expressed focally or positively in the form of palisades around the cancer nests. AB-PAS staining was positive. HPV test results: HPV16/18 was positive in ISMC (1/4); HPV16/18 was positive before surgery (4/6); no HPV was detected in SMILE; all ISMC cases expressed PD-L1. Eight ISMC patients were successfully followed up for 4-39 months (average 20.50 months), and four SMILE patients for 1-25 months (average 8.25 months). All followed-up patients survived; however, one ISMC patient developed multi organ metastases post-surgery. Conclusion: ISMC has unique morphological characteristics and immunophenotypes, indicated by high invasiveness and poor prognosis. All ISMC are PD-L1 positive, suggesting that these patients may benefit from PD-L1 immunotherapy.
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