The study of clinicopathologic features of cervical squamous carcinoma with invasive micropapillary like pattern and phenotype

Invasive micropapillary carcinoma has been reported in the adenocarcinoma of many organs including cervix, and many studies have proved it has more invasive biological behavior. This study, for the first time, reports cervical squamous carcinoma with invasive micropapillary like pattern and phenotype (IMLPP) and further investigates its clinicopathologic features. Cervical squamous carcinoma with IMLPP was selected by histological characteristics and immunohistochemical staining. All patients' clinical information and pathological parameters were collected. Based on histological characteristics and immunohistochemical staining results, 24 cases, out of 104 cases of cervical squamous carcinoma, were identified as having invasive micropapillary like pattern. The staining of all 24 cases with EMA and MUC- 1 showed the feature of "reverse polarity like". Meanwhile, patient age at diagnosis ( P=0.011), maximum invasion depth ( P= 0.001), maximum diameter (P= 0.015), lymphvascular space invasion (P<0.001), pelvic lymph node metastasis ( P<0.001), metastasis (P= 0.020), death ( P=0.025) and FIGO stages ( P= 0.001) were related to the existence of IMLPP, independently of the proportion of IMLPP to the whole tumor in size. Univariate and multivariate disease-free survival analyses (follow-up time > 12 months) showed significant statistical difference between cervical squamous carcinoma with or without IMLPP ( P= 0.016, P= 0.043). Results from our study suggested that IMLPP may be associated with aggressive biological behavior in cervical squamous carcinoma. Therefore, pathologists should pay attention to the existence of it, no matter its proportion with relation to the whole tumor, and bring it to the attention of clinicians.