探讨子宫颈浸润性复层产黏液的癌(ISMC)的诊断学特征。

回顾性分析2021年9月9日济宁医学院附属医院妇科收治的1例ISMC患者的临床资料，并复习文献总结其诊断学特征。

患者女性，34岁，经期延长半年余，阴道不规则流血1个月，于外院行宫颈癌筛查示人乳头状瘤病毒(HPV)33阳性，液基薄层细胞学检查(TCT)示非典型腺细胞，不能明确意义。妇科检查见宫颈膨大，质硬，直径约3 cm×4 cm；全腹部CT平扫提示宫颈占位性病变；宫颈活检病理提示鳞状细胞癌；行经腹宫颈癌根治术，术后病理示ISMC，大小2 cm×2 cm×1 cm，癌侵及宫颈管壁近全层，并累及神经，脉管内查见癌栓；免疫组织化学染色示P16 (+)，P63(+)，细胞角蛋白5/6(CK5/6)(+)，CK7(+)，细胞核增殖相关指数(Ki-67)(+，>75%))，最终确诊为ISMC。

ISMC易误诊为宫颈鳞状细胞癌，可行相关免疫组织化学染色鉴别。

To explore the diagnostic characteristics of invasive stratified mucin-producing carcinoma (ISMC).

Retrospective analysis and a study of the literature were performed on the clinical data of a female cervical cancer with ISMC who was admitted to the Department of Gynecology at the Affiliated Hospital of Jining Medical University on September 9, 2021.

In a nearby hospital, the patient′s cervical cancer screening revealed human papilloma virus (HPV) 33 is positive, while thin-prep cytology test (TCT) showed atypical adenosine cells with no apparent significance. The cervix was big and firm, with a diameter of about 3 cm×4 cm, according to the gynecological examination. A cervical space-occupying lesion was discovered on a full-body CT scan of the abdomen, and a cervical biopsy revealed squamous cell carcinoma. After a transabdominal radical excision of cervical cancer, postoperative pathology reported a 2 cm×2 cm×1 cm ISMC that had infiltrated the wall of the cervical canal, and affected nerves. In the vascular canal, a tumor thrombus was discovered. P16(+ ), P63(+ ), cytokeratin 5/6 (CK5/6)(+ ), CK7(+ ), and nuclear proliferation-associated index (Ki-67) (+, >75%) were all detected by immunohistochemical labeling.

It′s simple to mistake ISMC for cervical squamous cell cancer. It was possible to distinguish between the two by using immunohistochemical staining.