{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:04:53Z","timestamp":1785229493695,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["2025J01215"],"award-info":[{"award-number":["2025J01215"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["2025J01905"],"award-info":[{"award-number":["2025J01905"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology CR"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Primary signet\u2010ring cell carcinoma and poorly differentiated adenocarcinoma with poorly cohesive morphology in the cervix are rare conditions, and their clinicopathological features remain poorly described. This study defines primary cervical poorly differentiated adenocarcinomas meeting the diagnostic criteria for poorly cohesive carcinoma as outlined in the 2019 WHO Classification of Digestive System Tumors as \u2018HPV\u2010associated cervical poorly cohesive carcinomas\u2019 (HPV\u2010associated CPCC) and describe their clinicopathological and molecular features. Sixteen HPV\u2010associated CPCC cases were analyzed and classified into three histological subtypes: signet\u2010ring cell carcinoma (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094), not otherwise specified (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20096), and mixed types (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20096). All patients were Chinese (median age: 46\u2009years; range: 30\u201366). Vaginal bleeding was the primary presenting symptom (100.0%). High\u2010risk human papillomavirus (HPV) was identified in all tumors, with HPV\u201018 as the predominant genotype (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200913), HPV\u201016 in two cases, and a single case exhibiting concurrent infection with HPV\u201016, \u201018, and \u201058. Overall, 56.3% presented with advanced\u2010stage disease (International Federation of Gynecology and Obstetrics [FIGO] IIIB\u2013IVB), frequently involving regional lymph nodes (56.3%) and distant sites (18.8%). Histopathological examination revealed diffuse stromal infiltration (100%), lymphovascular invasion (75.0%), necrosis (75.0%), and desmoplasia. Immunohistochemically, all cases showed p16 block positivity. Variable expression of antibody\u2010drug conjugate targets was observed, with HER2\u2010low expression (33.3%), and positive staining for Trop\u20102 (85.7%), nectin\u20104 (42.9%), and tissue factor (92.3%). During follow\u2010up, disease\u2010specific mortality was 50.0%. The 3\u2010year overall survival rate was 56.3%, which was significantly lower in advanced\u2010stage disease (45.0%) than in early\u2010stage disease (75.0%). Whole\u2010exome sequencing revealed low tumor mutational burden (median 1.28 Muts\/Mb), recurrent mutations in AK1, ARHGAP39, KRT24, MICAL3, SLC6A9 (27.3%), KRAS, and KMT2C (18.2%), alongside MUC2 copy gain (63.6%) and bidirectional Y_RNA alterations (gain 54.5%\/loss 45.5%). Collectively, HPV\u2010associated CPCC represents a distinct and aggressive subtype characterized by distinctive histopathological features, a predominant association with HPV18, frequent presentation at advanced stages, and marked molecular and biomarker heterogeneity.\n                  <\/jats:p>","DOI":"10.1002\/2056-4538.70100","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:06:46Z","timestamp":1781492806000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological and molecular characterization of\n                    <scp>HPV<\/scp>\n                    \u2010associated cervical poorly cohesive carcinoma: a rare aggressive entity"],"prefix":"10.1002","volume":"12","author":[{"given":"Wei","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010jiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010mei","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Pathology The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010cheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajie","family":"Zhang","sequence":"additional","affiliation":[{"name":"The School of Basic Medical Sciences Fujian Medical University  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical Records Room Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuqin","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wucheng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010xiu","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of Pathology Xiapu County General Hospital (Xiapu County Hospital)  Ningde PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun\u2010cheng","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Pathology Ningde Hospital of Traditional Chinese Medicine, Affiliated to Fujian University of Traditional Chinese Medicine  Ningde PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong\u2010mei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pathology Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital  Fuzhou PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department 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