Anaplastic carcinoma associated with a mucinous cystic neoplasm of the pancreas during pregnancy:Report of a case and a review of the literature

Oncogenesis of anaplastic carcinoma of the pancreas is a subject of controversy, because it shows sarcomatous nature with extremely poor prognosis. We herein report an unusual case of anaplastic carcinoma occurring with a recurrent mucinous cystic neoplasm in a 38-year-old female. A 10-cm retroperitoneal cystic mass was pointed out in the first pregnancy and a probable diagnosis of mucinous cystic neoplasm was made in October 2000. She refused surgery first and delivered her baby uneventfully. During her second pregnancy in 2002, however, she presented hematemesis and underwent urgent distal pancreatectomy, splenectomy and partial resection of the gastric wall where the tumor perforated. A diagnosis of borderline-type mucinous cystic neoplasm with ovarian-like stroma was made. Nine months later, CT visualized a recurrent cystic tumor near the pancreatic stump, which was subsequently resected. Pathology revealed that the tumor was composed of two different components of borderline-type mucinous cystic neoplasm and anaplastic carcinoma. The latter was intensely positive for vimentin, CD68, p53 and focally for cytokeratin, suggesting both sarcomatous and carcinomatous differentiation. She survived four years after the second surgery without tumor recurrence. Although the origin of anaplastic carcinoma has not been determined yet, it should be remembered that anaplastic carcinoma can occur in association with mucinous cystic neoplasm of more benign histology.

Malignancy risk factors and prognostic variables of pancreatic mucinous cystic neoplasms in Chinese patients

BACKGROUND Pancreatic mucinous cystic neoplasms(MCNs)represent one of the precursor lesions of pancreatic ductal adenocarcinoma,and their detection has been facilitated by advances in preoperative imaging.Due primarily to the rarity of MCNs,however,there is limited knowledge regarding the prognostic variables and high-risk factors for malignant transformation.A more comprehensive and nuanced approach is necessary to fill this gap and provide a basis for improved treatment decisions and patient outcomes.AIM To investigate the high-risk factors associated with malignant MCNs and to explore the prognostic factors of MCN with associated invasive carcinoma(MCNAIC).METHODS All cases of resected MCNs from a single high-volume institution between January 2012 and January 2022 were retrospectively reviewed.Only cases with ovarian-type stroma verified by progesterone receptor staining were included.Preoperative features,histological findings and postoperative course were documented.Multivariate logistic regression was employed to investigate variables related to malignancy.Survival analysis was performed using the Kaplan-Meier curve,and the prognostic factors were assessed to evaluate the postoperative course of patients with MCN-AIC.RESULTS Among the 48 patients,36 had benign MCNs,and 12 had malignant MCNs(1 high-grade atypical hyperplasia and 11 MCN-AIC).Age,tumour size,presence of solid components or mural nodules and pancreatic duct dilatation were identified as independent risk factors associated with malignancy.The follow-up period ranged from 12 mo to 120 mo,with a median overall survival of 58.2 mo.Only three patients with MCN-AIC died,and the 5-year survival rate was 70.1%.All 11 cases of MCN-AIC were stage I,and extracapsular invasion was identified as a prognostic factor for poorer outcomes.CONCLUSION The risk factors independently associated with malignant transformation of MCNs included age,tumour size,presence of solid components or mural nodules,and pancreatic duct dilatation.Our study also revealed that encapsulated invasion was a favourable prognostic factor in MCN-AIC patients.

Difficulty with diagnosis of malignant pancreatic neoplasms coexisting with chronic pancreatitis

Chronic pancreatitis is a relatively common disease. We encountered two different cases of belatedly demonstrated pancreatic carcinoma featuring underlying chronic pancreatitis. The first case was one that was highly suspected as that of a malignancy based upon imaging study, but unfortunately, it could not be confirmed by intra-operative cytology at that time. Following this, the surgeon elected to perform only conservative bypass surgery for obstructive biliary complication. Peritoneal carcinomatosis was later noted and the patient finally died. The second case, a malignant mucinous neoplasm,was falsely diagnosed as a pseudocyst, based upon the lesion's sonographic appearance and associated elevated serum amylase levels. After suffering repeated hemoptysis,the patient was found to exhibit lung metastasis and peritoneal seeding. We reviewed some of the literature,including those studies discussing chronic pancreatitis predisposing to a malignant change. These two case analyses illustrate clearly that the diagnosis for such conditions, which is simply based upon imagery or pathological considerations may end up being one of a mistaken malignancy. Some of our suggestions for the treatment of such malignancies as revealed herein include,total pancreatomy for univocal mass lesion, and needle aspiration of lesion-contained tissue for amylase, CA199and CEA levels for a suspicious cystic pancreatic mass.

Blood group type antigens in pancreatic intraductal papillary mucinous neoplasms

BACKGROUND: There are few data on blood group(BG) types and types of pancreatic cancers. The aims of this study were to study BG types and BG-antigens in pancreatic intraductal papillary mucinous neoplasms(IPMNs). METHODS: BG type and tumor BG-antigen(glycoprotein) expression(studied by immunohistochemistry on tissue microarrays) were analyzed with regard to characteristics of 101 surgically resected pancreatic IPMNs. RESULTS: Non-O BG type predicted invasive carcinoma independently from high serum CA19-9 and male gender. BG type A was observed more frequently in women than in men. Chronic pancreatitis was more frequently seen in patients with BG type B or AB. Aberrant tumor expression(with regard to BG type) of loss of A antigen expression type occurred in 15.0% of IPMNs and of loss of B antigen expression type in 62.5% of IPMNs. Intraneoplasm BG-antigen expression was not related to dysplasia grade or invasion. CONCLUSION: The results of the study suggest that in pancreatic IPMN, non-O BG type predicted invasive carcinoma, whereas for intratumor BG-antigen expression no specific patterns were detected with regard to the progression of glandular epithelial dysplasia or invasion.

Pancreatic Carcinoma with Prominent Mucin Production: A Clinicopathologic and Immunohistochemical Study of 9 Cases

Pancreatic carcinoma occasionally associated with prominent mucin production and this type of tumor designated as PCM (pancreatic carcinoma with prominent mucin production) was diagnosed depends on subjective estimation of the amount of mucous area, and there has been no report on a quantitative evaluation of the amount of mucinous area in the tumor. To examine the feature of PCM, we analyzed 9 cases of PCM among 243 cases of pancreas carcinoma and evaluated the amount of mucin by imaging analysis. Morphologically, 5 cases were classified as intradactal papillary mucinous neoplasms (IPMN)-derived PCM and 4 cases were as ductal adenocarcinoma (DA)-derived PCM. Mucous composition was found to be more than 50% in all IPMN-derived PCM cases, and that was 40% - 50% in DA-derived PCM cases with one exception. IPMN-derived PCM cases showed expansive growth with pancreatic duct dilatation filled with mucin, while DA-derived PCM cases possessed mucin infiltration into interstitial tissue. Immunohisto-chemically, three of 4 DA-derived PCM cases were MUC1(–)/MUC2(+), and the results of expressions for p16 and Dpc4 suggesting that DA-derived PCM was similar to IPMN-derived PCM rather than ordinary DA. Survival rate of DA-derived PCM cases was lower than that of IPMN-derived PCM cases. We advocate that DA-derived PCM may constitute a borderline group between IPMN and ordinary DA.

Update on mucinous cystic neoplasm of the pancreas:a narrative review

Mucinous cystic neoplasm(MCN)of the pancreas is an exocrine cystic tumor with a potential of harboring malignancy.The latest World Health Organization classification of tumors of digestive system designates malignant MCN as MCN with associated invasive carcinoma(MCN-AIC).Since its separation from other pancreatic cystic tumors in 1978,much progress has been made in our understanding of MCN in epidemiology,clinical and pathological features,biological behavior,as well as prognostic characteristics.This review aims to summarize the current knowledge of MCN and MCN-AIC.

晚期肺炎型肺癌:一项中国单中心临床-放射-病理特征回顾性研究及预后分析

背景与目的肺炎型肺癌是一种临床和影像表现特殊的肺癌。本研究旨在总结此类肺癌的临床、影像及病理学特征,诊断手段,治疗方案及预后情况。方法肺炎型肺癌定义为:肺部计算机断层扫描(computed tomography, CT)以磨玻璃或实变影为主要表现,经组织学或细胞学明确诊断的肺癌。收集2013年1月1日-2018年8月30日期间,就诊于北京协和医院呼吸与危重症医学科的晚期肺炎型肺癌病例,回顾性分析这些患者临床资料并进行生存随访。结果共纳入46例患者,均为肺腺癌。咳嗽(41/46, 89.1%)、咳痰(35/46, 76.1%)是最常见的临床表现。胸部CT常见表现为磨玻璃影(87.0%)、实变影(84.8%)、以及多发磨玻璃结节(84.8%),多发囊样变和空洞分别为40.0%和13.0%。同侧及对侧肺转移分别见于95.3%和84.8%的病例。从出现症状到明确诊断的中位时间为214天(95%CI:129-298)。CT引导肺穿刺活检及外科肺活检的确诊率为100%,支气管镜下的支气管肺泡灌洗(BAL)联合经支气管肺活检(TBLB)的确诊率为80.9%(17/21),痰液病理学检查的确诊率为45.0%(9/20)。病理亚型,26例(26/46, 56.5%)为浸润性粘液腺癌,20例患者因缺乏足够的病理标本量而无法进一步区分亚型。38例进行了EGFR基因检测,6例(6/38, 15.8%)有突变。33例进行ALK基因检测,仅1例(1/33, 3.0%)有ALK重排。中位总生存期(overall survival, OS)为522天(95%CI:424-619)。EGFR野生型或ALK融合基因阴性的患者,化疗明显延长中位OS(HR=0.155, P=0.002,2),接受化疗者中位OS 547天(95%CI:492-602),不接受化疗者中位OS 331天(95%CI:22-919)。结论肺炎型肺癌由于其临床和影像特征与肺部感染相似而经常导致延误诊断。支气管镜下的BAL联合TBLB有相当高的确诊率。浸润性粘液腺癌为肺炎型肺癌的主要病理亚型。肺炎型肺癌EGFR突变及ALK重排发生率很低。对于无明确驱动基因的患者,应积极行化疗,延长患者生存期。

乳腺腺样囊性癌与浸润性筛状癌的形态及免疫组化比较

目的探讨具有筛状结构的乳腺腺样囊性癌与浸润性筛状癌的形态和免疫组化特点及诊断、鉴别诊断要点。方法对具有筛状结构的乳腺腺样囊性癌及浸润性筛状癌各3例进行形态和免疫组化比较观察。结果在常规HE染色下,乳腺腺样囊性癌的筛状结构与浸润性筛状癌十分相似,但它们的免疫标记谱不同。乳腺腺样囊性癌的导管上皮细胞表达c-kit;肌上皮细胞表达p63、SMA;不表达ER、PR。浸润性筛状癌不表达c-kit,p63及SMA;总是表达ER、PR。结论乳腺腺样囊性癌是罕见的肿瘤,它的筛状结构与浸润性筛状癌非常相似。免疫组化标记c-kit;p63、SMA及ER、PR有助于它们的鉴别。

子宫颈浸润性复层产黏液的癌6例临床病理分析

目的探讨子宫颈浸润性复层产黏液的癌(invasive stratified mucin-producing carcinoma,ISMC)的临床病理学特征及预后。方法回顾性分析2019~2021年褔建省肿瘤医院诊治的6例子宫颈ISMC的临床病理学及免疫表型特征,并复习相关文献。结果6例均可见经典的ISMC形态,实性癌巢由胞质内黏液多少不等的复层上皮细胞组成,边界较圆钝,巢周细胞呈栅栏状排列,类似子宫颈产黏液的复层上皮内病变。转移灶与原发灶形态一致或癌巢较不规则。免疫表型:肿瘤细胞p16、CEA、CK7、CK8/18均阳性,ER、PR、PAX8和Syn均阴性,CK5/6、p40阴性或灶性阳性,Ki-67增殖指数为70%~80%。结论子宫颈ISMC是新近命名的HPV相关的腺癌亚型,具有独特的形态学及免疫表型特征,预后较其它HPV相关腺癌差,识别子宫颈癌中ISMC成分具有临床意义。

CXCL12／CXCR4在涎腺腺样囊性癌及周围神经组织中的表达

目的:探讨趋化因子CXCL12及其受体CXCR4与涎腺腺样囊性癌嗜神经侵袭之间的关系。方法:涎腺腺样囊性癌病倒标本41例.舌癌病例标本30例,腮腺多形性腺瘤病例标本20例,正常神经组织标本20例。所有标本均制成4μm厚的切片。应用EnVision法检测CXCR4在腺样囊性癌肿瘤组织内的表达以及CXCL12在周围神经组织内的表达。结果:腺样囊性癌癌组织内CXCR4阳性表达率为63.41%,显著高于舌癌(36.67%)及多形性腺瘤(35%)(P<0.05);周围神经组织内CXCL12高表达(64.38%),在腺样囊性癌内的神经组织与舌癌内的神经组织及正常神经组织中CXCL12阳性率无显著差异。结论:趋化因子受体CXCR4在腺样囊性癌中高表达,趋化因子CXCL12在周围神经组织内高表达,提示CXCL12/CXCR4可能在腺样囊性癌嗜神经侵袭中发挥重要作用。

腺样囊性癌两个细胞系体外侵袭能力比较

目的 研究转移潜能不同的两个腺样囊性癌细胞系体外侵袭能力的差异。方法 选用肺低转移细胞系 Acc- 2和从中筛选出的肺高转移细胞系 Acc- M,利用 MTT法检测与几种基底膜成分的粘附能力 ;划痕法检测运动能力 ;PAGE底物酶谱法检测分泌 型胶原酶的能力 ;改良勃顿小室法观察对重组基底膜的侵袭能力。结果 11小时后Acc- 2细胞系对 3种细胞外基质的粘附率分别是纤维粘连蛋白 (FN) 6 1.8%、层粘连蛋白 (L N) 4 2 .9%和基底膜胶(Matrigel) 6 0 .4% ,Acc- M细胞系的粘附率分别是 FN79.4%、L N71.1%、Matrigel6 9.8%。 2 12小时终止实验时 ,测定 Acc- 2细胞系和 Acc- M细胞系的运动速度分别是1.15μm/h和 2 .2 6μm/h。 3Acc- M细胞系的培养上清中可以检测到 型胶原酶活性 ,而 Acc- 2细胞系的培养上清中检测不到 型胶原酶活性。 48小时终止实验时 Acc- 2细胞系和 Acc- M细胞系对重组基底膜的侵袭率分别是 6 8.0± 4.35和 10 3.2± 5 .6 3。结论 两个腺样囊性癌细胞系的异质型粘附能力、运动能力、分泌 型胶原酶的能力及侵袭重组基底膜能力明显不同 。

乳腺腺样囊性癌与浸润性筛状癌的鉴别诊断探讨

目的探讨乳腺腺样囊性癌与浸润性筛状癌的鉴别诊断。方法收集乳腺腺样囊性癌及浸润性筛状癌各6例进行形态和免疫组化比较观察。结果乳腺腺样囊性癌与浸润性筛状癌的形态学十分相似,但它们的免疫组化表达不同。乳腺腺样囊性癌的导管上皮细胞CD117(+),肌上皮细胞calponin、p63和SMA(+);ER、PR(-)。浸润性筛状癌CD117、calponin、p63和SMA(-),ER和PR(+)。结论乳腺腺样囊性癌,一种罕见的特殊类型乳腺癌,具有低度浸润潜能,其组织学形态与浸润性筛状癌非常相似。免疫组化标记CD117、calponin、p63、SMA及ER、PR有助于它们的鉴别。

乳腺浸润性筛状癌的临床病理及免疫表型

目的探讨乳腺浸润性筛状癌(invasive cribriform carc inom a,ICC)的临床病理及免疫表型特点。方法收集6例ICC的临床资料,观察它们HE形态,并进行免疫组化检测,选用的一抗有CK5、CK(34βE12)、CK8、S-100蛋白、SMA、CD10、ER、PR、c-erbB-2、CgA、PCNA、E-cad。结果本研究将ICC分为两组:经典型和混合型。它们具有以下特征:①以浸润性筛状结构占优势,细胞排列成浸润性的有棱角的岛屿状,筛孔较不规则。肿瘤细胞小,呈低或中级核级,核分裂象罕见。在多数癌巢周围有反应性纤维母细胞性间质增生。②免疫表型:肌上皮标记(S-100蛋白、SMA、CD10)及CK(34βE12)肿瘤细胞巢均阴性,而个别肿瘤累及的TDLU周围部分肌上皮标记阳性;激素受体(ER、PR)均阳性;c-erbB-2阴性,PCNA、E-cad呈不同程度的阳性;CgA均阴性。③临床资料:经典型ICC年龄均值较混合型ICC大,肿块大小较混合型ICC小,病程较混合型ICC短,腋窝淋巴结转移少见,转移灶仍保持筛状结构。结论ICC有其独特的组织学特征及免疫表型,是一种独立的临床病理类型。

CDH4对涎腺腺样囊性癌细胞侵袭力的影响

目的探讨CDH4对涎腺腺样囊性癌(SACC)细胞侵袭和转移能力的影响。方法以人SACC高转移细胞株SACC-M为研究对象,利用CDH4小分子干扰RNA对CDH4基因进行沉默,Western blot检测转染前后CDH4蛋白的表达变化,体外侵袭实验比较细胞侵袭能力的变化,体外迁移运动实验比较细胞运动能力的改变。结果 CDH4siRNA明显下调CDH4基因的表达。CDH4表达下调后,SACC-M细胞体外侵袭能力显著降低,体外迁移运动能力明显降低。结论 CDH4可以明显地促进SACC细胞的体外侵袭和迁移运动,提示CDH4可能在SACC的恶性进展中起着重要作用。

FZD2基因与涎腺腺样囊性癌增殖及侵袭转移能力的关系

目的探讨FZD2基因表达与涎腺腺样囊性癌转移的相互关系及其对癌细胞增殖和侵袭能力的影响。方法采用免疫组织化学方法分析FZD2基因在转移和非转移的涎腺腺样囊性癌组织样本中的表达,并采用siRNA干扰技术下调FZD2基因的表达,观察FZD2基因表达对涎腺腺样囊性癌细胞增殖能力、侵袭能力的影响。结果 FZD2基因在涎腺腺样囊性癌非转移样本中阳性表达高于转移样本;在高转移涎腺腺样囊性癌细胞中FZD2基因表达被抑制后细胞增殖能力提高,侵袭能力增强。结论 FZD2基因可能对涎腺腺样囊性癌增殖及侵袭转移有抑制作用。

正丁酸钠对涎腺腺样囊性癌细胞株ACC-2侵袭、迁移的影响及机制研究

目的探讨不同浓度正丁酸钠对涎腺腺样囊性癌细胞株ACC-2侵袭、迁移的影响与其作用机制。方法噻唑蓝(MTT)法探索正丁酸钠作用ACC-2细胞的最佳浓度,Transwell小室实验检测正丁酸钠对ACC-2细胞侵袭、迁移能力的影响,Western blot和实时荧光定量PCR(RT-PCR)分别检测5组浓度药物作用后ACC-2细胞中高迁移率族蛋白1(HMGB1)、TLR4的mRNA和蛋白的表达。结果与对照组相比,0.625、1.250、2.500、5.000、10.000 mmol/L 5组浓度的正丁酸钠均能抑制ACC-2细胞增殖(P<0.05)且呈明显浓度依赖性;5组浓度正丁酸钠对细胞侵袭能力的影响差异无统计学意义(P>0.05);2.500、5.000、10.000mmol/L浓度正丁酸钠可以抑制ACC-2细胞的迁移能力(P<0.05),同时降低ACC-2细胞HMGB1、TLR4的mRNA及蛋白表达(P<0.05);相关性分析显示TLR4蛋白表达的降低与HMGB1的抑制呈正相关(r=0.810,P<0.05)。结论正丁酸钠能够抑制ACC-2细胞增殖,浓度较高时可以抑制ACC-2细胞的迁移能力,同时降低HMGB1、TLR4的mRNA与蛋白表达,提示NaB对ACC-2迁移能力抑制可能通过下调HMGB1、TLR4的mRNA及蛋白表达来实现。

RhoA和Snail在涎腺腺样囊性癌中的表达及意义

目的探讨Rho A和Snail在涎腺腺样囊性癌(SACC)中的表达及其与癌症侵袭转移的关系。方法采用免疫组织化学方法检测Rho A和Snail在55例SACC(SACC组)与20例癌旁正常组织(对照组)中的表达情况,分析Rho A和Snail的表达与SACC临床病理特征的关系及其在SACC组织中表达的相关性。结果 SACC组的Rho A(69.1%vs 5.0%)和Snail(72.7%vs 10.0%)蛋白阳性表达率高于对照组(均P<0.05);有淋巴结转移者的Rho A和Snail阳性表达率高于无转移者,Ⅲ+Ⅳ期的Rho A和Snail阳性表达率高于Ⅰ+Ⅱ期者;实体型的Rho A阳性表达率高于筛孔型,实体型和管状型的Snail阳性表达率高于筛孔型(均P<0.05),而不同性别、年龄及肿瘤部位的Rho A和Snail阳性表达率差异无统计学意义;Rho A和Snail在SACC中的表达呈正相关(rs=0.414,P<0.001)。结论 Rho A和Snail蛋白可能通过Rho A/ROCK/PKD1/NF-κB/Snail信号传导通路联合作用促进了SACC的浸润和转移。

宫颈浸润性复层产黏液性癌2例临床病理观察

目的探讨宫颈浸润性复层产黏液性癌(ISMC)的临床病理特征、鉴别诊断及预后。方法收集并分析2例ISMC的临床病理学特征、免疫表型特点及预后,并复习相关文献。结果患者女性,年龄均为39岁,发病部位均为宫颈,临床均有HPV感染,其中ISMC合并普通型中分化腺癌1例,ISMC合并产黏液的复层上皮内病变(SMILE)及高级别鳞状上皮内病变(HSIL) 1例。镜下见肿瘤细胞呈实性片状、巢团状及腺管状排列,瘤细胞呈圆形、卵圆形及柱状,细胞胞质丰富,部分嗜碱性,部分胞质空亮,内见黏液,核异性明显,核分裂象及凋亡小体易见。免疫组化:2例肿瘤细胞CK7、CEA、p16均弥漫(+),Ki-67高增殖指数,1例CK5/6及p63为(-),另1例CK5/6及p63为局灶(+)。结论 ISMC是新近认识的一种罕见的女性生殖道肿瘤,与HPV感染相关,容易出现误诊及漏诊,需提高对本病的认识,诊断主要依赖于其独特的临床病理特征和免疫表型。

子宫颈浸润性复层产黏液的癌22例临床病理分析

目的探讨子宫颈浸润性复层产黏液的癌(invasive stratified mucin-producing carcinoma,ISMC)的临床病理学特征、诊断、鉴别诊断及预后。方法回顾性分析22例子宫颈ISMC的临床资料,分别行免疫组化EnVision两步法染色、PAS染色,应用qRT-PCR法进行HPV检测,并进行电镜观察。结果22例子宫颈ISMC患者年龄32~68岁,中位年龄47岁,平均45.9岁。镜下见肿瘤细胞呈实性片状、巢团状或腺管状排列,瘤细胞呈圆形、卵圆形及柱状,细胞质丰富,部分胞质空亮,胞质内可见多少不等的黏液,周边细胞栅栏状排列,细胞均无角化或细胞间桥形态出现。所有病例均可见腔缘的核分裂象或凋亡小体(22/22),多数病例可见中性粒细胞浸润(17/22)。免疫表型:p16均弥漫强阳性,CK7、CAM5.2、CEA弥漫阳性或部分阳性,CK5/6、p40、p63散在阳性或阴性,PAX-8部分局灶阳性,ER、PR阴性。PAS染色均可见多少不等的细胞内黏液。qRT-PCR结果显示22例患者均与高危型HPV感染有关。电镜显示细胞表面有许多微绒毛,可见胞质内空腔及大小较一致的黏液空泡,核膜清晰。肿瘤细胞间以缝隙连接为主,未见桥粒结构,并且缺乏细胞张力丝。多数患者行广泛全子宫+双侧附件及双侧盆腔淋巴结清扫术,部分年轻患者及有特殊要求的患者保留双侧附件或双侧卵巢,术后辅助放、化疗或联合放化疗。22例患者中有21例存活,1例死亡(术后6个月)。结论ISMC是与HPV感染有关的、少见的子宫颈腺癌,具有HPV相关型腺癌的形态学特点,易与低分化鳞状细胞癌混淆,患者预后相对较差。

宫颈浸润性复层产黏液性癌1例临床病理分析及文献复习

目的:探讨宫颈浸润性复层产黏液性癌(ISMC)的临床病理学特征、鉴别诊断和预后。方法:观察和分析1例ISMC的病理形态学特征及免疫表型,并复习相关文献。结果:镜下肿瘤呈浸润性生长并伴有促纤维结缔反应。瘤细胞呈圆形或卵圆形,排列成巢状或假腺腔样。胞质嗜酸性,部分胞质内含少量黏液。细胞核异型性明显,可见核分裂象及凋亡小体。癌巢周围可见淋巴细胞、浆细胞及中性粒细胞浸润。P40及P63均呈局灶核阳性并分布于病变靠近基底部。特殊染色PAS及AB显示少数肿瘤细胞阳性。结论:ISMC为侵袭性癌,组织形态学上与复层产黏液性上皮内病变(SMILE)类似。宫颈ISMC较为罕见,了解ISMC特征性病理表现及免疫表型,有助于临床病理医生正确诊断该疾病以及制定出合理的临床治疗方案。