Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.