A smear from the cervix for cytology. A smear for cytology from the vagina. Differences between a cytological study and an analysis for oncomarkers
A special examination of smears for cytology, also called the Pap test in women, is very effective method research, which, as a result of the study, is capable of detecting a malignant formation at the earliest stage of the disease and helping to prescribe timely treatment.
When doctors talk about a cervical cytology test, they plan to subject the woman to the following procedure: Samples will be taken from her vagina and cervix and examined under a microscope. Cytological analyzes are recognized as the most effective way to determine the presence of inflammation or the formation of cancer cells in the female genital organs.
It is often compared with analyzes for a cytological study with a histological examination, however, there is one significant difference between them: the method of cytological examination is non-invasive, which means that it is not necessary to make a puncture in the tissues of the female genital organs to conduct this study. Cytological analysis is carried out using a painless smear from the cervix or taking an imprint.
In order for the analysis to provide reliable information, it is very important to follow all the rules for preparing the patient for it. Deciphering the analysis, of course, should be the doctor who treated the woman and has access to her medical record.
The obvious advantage of the cytological method is that it takes a lot of time to conduct the study. One day is enough for an ordinary doctor to perform this analysis and prescribe a treatment that normalizes the cervix. If the study shows that the patient is suffering from any oncological process, this information will not be considered one hundred percent. In order to confirm or refute them, the doctor will resort to a biopsy, which eliminates all existing doubts.
If the patient has some contraindications for a biopsy, the doctor will have to rely on the cytology data and consider them correct until a safe way to prove the opposite is found. Also, a cytological analysis of the cervix is very helpful for doctors on days when they need to examine a large number of patients in the shortest possible time.
Characteristics of a smear for cytology
A cytology smear is also called a Pap smear. To implement it, doctors examine the resulting smear from the cervix under a microscope. The purpose of the process is to diagnose possible oncological diseases at an early stage.
Cytological examination of cervical smears indeed successfully detects malignant tumors that have affected the reproductive organs of a woman. It is also able to provide information about the formation of microflora, the presence of which can be dangerous for the vaginal environment. Doctors acknowledge that a cervical examination is not guaranteed to be accurate. If a dangerous microflora is found in the vagina, the woman will receive a referral for an additional examination. Another doctor will take a swab from her for flora and perform an STD test.
Cytology is not a new word in medicine. Domestic doctors have been using the study for several decades. The method is valuable in that it allows you to identify up to 5 types of changes at the cellular level of the patient. Doctors recommend that all women, whose age ranges from 18 to 65 years, undergo this examination at least once a year.
Indications for a cytology smear
Realizing that many women do not take their health seriously and will not conduct cytological tests without a reason, the doctors formulated a number of signs that, having found in themselves, a woman should immediately go for analysis. Among these signs are:
- Any inflammatory processes in the reproductive organs;
- Menstrual irregularities that persist for several months;
- reproductive problems;
- Planning for pregnancy or insertion of a spiral to prevent it;
- Taking any hormonal drugs;
- Diabetes;
- Obesity;
- Damage to the body by viruses such as papillomas or genital herpes;
- Active sex life, which is unprotected sex with unverified partners.
Any of these signs is enough for a woman to put aside all her affairs in a distant box and go to the nearest one. medical Center for cytology. Doctors urge potential patients not to wait until their condition worsens and the first painful symptoms of the disease appear.
Contraindications for cytological examination
Despite the fact that doctors consider smear examinations to be safe and painless, there are a number of contraindications for it:
- A female genital swab (including a sample from the vagina or cervix) cannot be taken during menstruation;
- It is impossible to carry out the analysis in the presence of an inflammatory reaction in the vagina and cervix. With a developing infection in the blood, the number of leukocytes increases, which will affect the test results.
What precedes a cervical cytology test?
So that cytology does not give a false positive or false negative result, it is important to follow a number of rules that the patient will be familiarized with by her attending physician:
- Douching is not allowed before the procedure;
- Acceptance of any medicines local action;
- Do not urinate for at least 3 hours before the test;
- You can not enter into intimacy with a man, at least 2 days before the analysis;
- It is necessary to wait until the inflammatory process, accompanied by abundant secretion, subsides so that the increased number of leukocytes does not affect the results of cytology.
How to carry out cytology of the cervix?
Cytological examination of cervical smears is carried out by a gynecologist directly during the examination of the patient. The doctor carefully examines the woman's vagina using miniature mirrors. Next, they examine the cervical canal and cervical mucosa. The biological material is collected by the doctor immediately from the vagina, cervical canal and the entrance of the cervix.
The material remaining on the brush is carefully spread over the glass slide, dried and transferred to the laboratory, where it will be studied. For analysis, laboratory assistants will stain the smear with special preparations and carefully examine it under a microscope.
The laboratory technicians conducting the analysis are concerned about such characteristics of the material under study as the size of the cells, their number and location.
After the analysis, the patient does not have to stay in the clinic. She can return to her daily duties outside of her. However, young professionals sometimes touch the blood vessels, and in this case, the patient will have to put up with pain in the perineum and blood discharge for 1-2 days.
Deciphering the results of a cytological examination of the cervix
When the patient is perfectly healthy, cytology will find that her cervix is protected by a columnar epithelium and her vagina is flat. If the epithelium required in accordance with the norm is not detected during examination of a sample from the cervix, then doctors will be able to diagnose a woman with an oncological problem.
Pap test interpretation
According to the Papanicolaou method, a sample from the vagina and cervix, obtained by the cytological method, can be divided into 5 classes, depending on what the epithelium is, examined under a microscope.
Class 1. There are no pathological metamorphoses in the epithelium, all cells in the smear from the cervix appear healthy and have standard sizes and location.
Class 2. The morphological norm of epithelial cells is reduced. Probably, an infection is born in the vagina - most likely, vaginosis. Further diagnostics are needed to help formulate an accurate diagnosis.
Class 3. An insignificant part of the cervical epithelial cells has problems in the structure of the nucleus or cytoplasm. The patient is recommended to repeat the cytological examination of the cervix, in which a serious disease can be diagnosed.
Class 4. A significant part of epithelial cells are subject to malignant changes. The patient has a precancerous condition.
Grade 5. Almost all of the cells in the patient's smear are atypical. The woman is ill with cancer, which is still at an early stage.
Smear analysis for cytology according to the Betsed method
If the material used for analysis was taken not from the cervix, but from the cervical canal, the doctors use the Betsed method to decipher it. With it, the location of the cells and the metamorphoses that the nucleus encountered are especially important.
If the analysis did not reveal any deviations, no special designations will be indicated in the results.
By designating HPV, doctors will indicate a possible vaginosis or koilocytosis.
If the patient sees CIN in the transcript of the samples from the cervical canal, then the analysis showed her cervical dysplasia, and the word Carcinoma speaks of an oncological disease of the cervix.
How many days is a smear analysis done for cytology
The term for obtaining the results of the analysis is directly related to the clinic in which it was made, and can vary from 1 to 5 days.
Cytology is a diagnostic method that allows you to study the structure of cells and detect the presence of atypical elements that indicate the development of the disease. In gynecology, cytology analysis is a fairly common procedure.
The popularity of the method is easy to explain:
- firstly, a diagnostic smear for cytology does not require large expenses;
- secondly, a guarantee of a reliable result in the shortest possible time;
- thirdly, it helps to prevent the development of precancerous and cancerous conditions.
Cytology, a smear for cytology or oncocytology - these are all folk synonyms medical term- Papanicolaou test.
Analysis for the study of cells in gynecology
The cervical canal or cervix is an anatomical site for sampling cellular material for research in gynecology. This anatomical site functions with two types of epithelium:
- stratified epithelium (covers the area of the vaginal part);
- columnar epithelium (lines the cervical canal at the junction of the cervix and uterus).
According to physiological norms, cellular elements are regularly updated. Taking a smear for cytology in these parts of the cervical canal helps to detect atypical cancer cells at an early stage of development.
Carrying out an analysis for cytology ensures the identification of initial changes in the cervical canal of the uterus, contributing to the development of cancer for a short time. Given this reason, a cytology test is a mandatory preventive method in gynecology.
Mass smearing in women belonging to different age groups and segments of the population shows a positive trend in reducing the incidence of cervical cancer.
If your appointment list says a cytology smear, don't panic! This does not mean that you have cancer or that you are at increased risk of developing it. Not at all, a constant preventive examination and a smear for cytology, delays the possibility of developing terrible diseases.
Women under 65 should visit a gynecologist regularly and follow all prescribed requirements. After 65 years, the frequency of delivery of material for cytology is determined individually by the attending physician.
A Papanicolaou test is required in the following cases:
- All girls/women over the age of 18. In this case, the analysis is carried out without medical requirements, at will;
- Having a sexual life;
- Women over 30 years of age are required to undergo a mandatory medical test once a year;
- Pregnant. Cytology is carried out according to the rules 3 times during the period of gestation;
- Interruptions in menstrual cycle, the presence of human papillomavirus and malignant tumors in close family members are the reasons for a smear for cytology every six months.
Factors leading to gynecological diseases and a negative result of a cytology test:
- nicotine intake;
- Deficiency of vitamins A, C;
- Immunodeficiency states, not excluding HIV;
- Infection with chlamydial and herpetic infection;
- Long-term inflammatory foci of the genital organs of a woman;
- Isolation of the human papillomavirus in the blood;
- Systematic use of hormonal contraceptives;
- Beginning of sexual activity earlier than 16 years;
- Regular change of sexual partners;
- Several births in history.
Stages of preparation for the delivery of the analysis
It is difficult to predict what the doctor will prescribe at the next visit to his office. But if you are going to undergo a regular preventive examination by a gynecologist and pass a series of necessary tests, follow these simple recommendations:
- Forget about nighttime pleasures for a few days;
- Push it all away chemicals For intimate hygiene, stop douching;
- Medicines, such as vaginal suppositories, sprays, etc., should not be used before taking a smear.
A smear for cytological examination is taken during a routine gynecological examination with mirrors. The duration of the entire procedure, including examination, is 15 minutes.
Initially, the doctor assesses the condition of the walls of the vagina and the visible part of the uterus after the introduction of the gynecological "mirror". After that, the gynecologist proceeds directly to the sampling of the epithelium of the cervical canal. This will require a probe, a special swab or brush. Although the procedure is short and unpleasant, try to relax, otherwise, due to muscle tension, discomfort will increase.
The resulting scraping is immediately sent to the laboratory for further study. Accurate results from the laboratory will arrive after 1 to 2 weeks.
The results will indicate the item "positive" or "negative". It is quite clear that if the decoding contains the item “negative” - this means the absolute health of the cervix, the absence of atypical cells.
The item “positive” is not a clinical diagnosis! Yes, such a result indicates the presence of atypical cells, but this does not mean at all that they will soon become cancerous or already are. An analysis with a positive result occurs in infectious diseases obtained sexually, and even in inflammatory processes.
The decoding additionally includes the stages of the identified process:
- stage 1 - the cytological picture is not changed;
- Stage 2 - there are minor deviations from the norm due to inflammation;
- stage 3 - single cells with abnormalities of cellular elements (presumably of a malignant nature);
- Stage 4 - single cells of an exclusively malignant nature;
- Stage 5 - malignant cells in large numbers (accurate diagnosis - cancer).
In the case of a positive result, regardless of the stage, additional studies will be prescribed, for example, a repeat cytology test with doubtful results, or a colposcopy.
General condition after taking material for cytology
Do not worry if within 5 days after taking a smear, a brownish-green discharge appears. This is a normal reaction of the body that does not require treatment. On such, not too joyful days, gynecologists advise using personal hygiene products.
To avoid pain and discomfort, take a week-long break from sexual activity.
Urgently consult a doctor if, after taking the material for analysis, the body temperature has increased, there are sharp pains in the lower abdomen and bloody copious discharge.
Cytological analysis (from the Greek "cytos" - cell) is a study of the number, structure and shape of cells and an intercellular component obtained from a living organism, under an optical microscope. It allows you to identify pathological changes in the early stages and clarify their localization quite quickly, unlike other instrumental methods.
Cytological analysis is one of the most common diagnostic methods in gynecology and obstetrics.
In the women's health clinic, various fluids (vaginal and menstrual secretions, urine) and (more often) surface layers of cells that are taken from various parts of the reproductive system are subjected to cytological examination.
For example:
- vulva;
- vagina;
- cervix and cervical canal (internal cervical canal);
- internal cavity of the uterus;
- fallopian tubes;
- ovaries.
For the cytology of the external sections (to the uterus), freely exfoliating layers of cells are required, therefore this study belongs to fairly painless, fast (from several minutes during surgery to several days during a routine examination) and mass methods recommended for the annual routine examination of women from 18 ( subject to the onset of sexual activity) or 30 to 65 years.
Representatives of risk groups for oncology are examined 2 times a year; cancer patients on treatment and endocrinological patients - more often, according to indications.
To study the cellular composition of deeper organs, additional measures:
- endoscopy (uterus);
- organ punctures;
- washings and impressions obtained during laparoscopy, open incision or during surgical operations.
A smear for cytology includes the study of the surface (epithelium) and middle (mesothelium) layers of organs, as well as other included components, and is used to solve several problems.
They are:
An analysis for cytology in gynecology is one of the most informative studies (for example, when establishing hormonal activity, cytology successfully competes with a blood test), however, the degree of its reliability is directly dependent on the qualifications of the doctor taking the material, on the strict adherence to the rules for staining and sample preparation and from the correct choice of the place of the fence.
Therefore, the method requires a systematic repetition, and if deviations are found, supplements with a comprehensive examination.
Varieties of cytological tests
Cytological analysis has been known in gynecology since the beginning of the 20th century, when the Greek physician Georgios Papanikolaou first used it for the early diagnosis of cervical cancer. Currently, several new methods have been developed showing improved reliability.
The procedure for carrying out manipulations during the sampling of material remains common for all these types, the differences relate to the methods of preparation, processing and analysis of the sample taken.
For example:
The study of the prepared sample is traditionally carried out by a cytologist visually, using a strong microscope, however, in last years there was also a hardware analysis.
Differences between cytological and histological analyzes
Sometimes diagnosticians need to study not individual cells, but their relative position and the nature of the intercellular space. In this case, the patient is referred for histology (from the Greek "histos" - tissue) - the collection and further examination of a small fragment of tissue (structurally and functionally related group of cells).
Features of histological examination:
- refers to biopsy methods;
- requires more complex preparation;
- carried out in a hospital;
- performed under anesthesia;
- differs by a more labor-intensive technique of aiming when taking;
- requires complex processing of the selected material;
- hardware learning is required.
Tissue sampling is not indicated in the presence of very small foci of the detected lesion.
Histology is commonly used to diagnose human papillomavirus (HPV) and the level and stage of the cancer.
Differences between a cytological study and an analysis for oncomarkers
Tumor markers are specific protein molecules that can be produced by both altered and healthy cells of the body in the presence of disorders.
For example:
- inflammatory process;
- benign formations;
- when smoking;
- when taking medicines;
- during pregnancy, menstruation and other physiological changes;
- depends on age.
Therefore, the test for markers is also not 100% reliable. The analysis requires the study of venous blood, urine and other fluids.
The objectives of the study are similar to the analysis for cytology:
- detection of the presence of a tumor and determination of its nature (oncological or benign);
- evaluation of the effectiveness of anticancer therapy;
- search for metastases and recurrences.
Analysis for tumor markers is used for women at risk for cancers of the reproductive system, digestive system and other organs and is not used for preventive examinations. Sometimes the method is used to clarify the results of a cytological test.
Many tumor markers reveal different diseases, so this test requires a comprehensive examination.
The advantage of the test for gynecology is the ability to determine changes in the organs above the cervix (ovaries, uterus, fallopian tubes). The test for tumor markers requires more careful preparation of the patient due to the high sensitivity of the objects of study to physiological fluctuations.
Differences from microbiological analysis (smear on flora)
A smear from the vagina, cervical canal, urethra and rectum for microflora (pathogenic, symbiotic and opportunistic microorganisms) is performed through manipulations similar to a smear for cytology, and is included in a routine gynecological examination recommended for every six months for every woman.
Usually both types of smear are taken at the same time. Cultures may be required for microbiological analysis. Microscopy for bacterioflora is performed using a different staining method (Gram).
Indications
Cytology analysis in gynecology is part of the screening examination of the adult female population in many countries of the world. A planned cytology test is mandatory for all women over 18 (this age decreases with an earlier onset of sexual activity) and under 65 years of age.
At an older age (due to a decrease in estrogen levels and a decrease in the reliability of the result), a smear is prescribed at the discretion of the gynecologist. The focus group includes women over 30 years of age.
For women of screening age, in the absence of positive test results (that is, in the absence of detected pathologies, stage 1 cytogram) for 2 years, the planned period is postponed for every 2 years, with a negative result within 3 tests - for 3 years.
Indications for an unscheduled cytological examination may include:
Test tolerance
Screening cytological examination is carried out on cells no further than the outer part of the cervical canal and refers to non-invasive methods.
Taking freely exfoliating cells from the vagina does not cause discomfort, the patient experiences some discomfort when taking material from the surface of the cervix and from its canal, however, this procedure is short-term and also does not include penetration into the deeper layers.
To reduce discomfort, the gynecologist can preheat the instruments in hot water. This study is rightfully considered a trivial medical procedure and should not cause concern.
Women who are forced to frequently take a smear for cytology (for example, cancer patients) get used to these manipulations very quickly, which should serve as excellent evidence for women who avoid this test due to fear of pain or possible complications.
Preliminary preparation
The reliability of the results of a cytological study to a large extent depends on proper preparation and a well-chosen time to visit a gynecologist.
A smear should not be taken under the following conditions:
How is material collected for analysis?
A cytological smear is taken during a routine gynecological examination, which takes no more than 15 minutes and does not require any other special preparation from the patient. After setting up the dilator and introducing the mirrors, the specialist makes a scraping from the vaginal wall, the outer surface of the cervix and from the canal with a spatula or brush, places the smear on a glass slide and sends it to the laboratory assistant.
How long to wait for a response?
In emergency situations (for example, when performing a surgical intervention), the result of cytology is provided to the surgeon within a few minutes, before the completion of the operation. Waiting for a response during a scheduled screening examination in a antenatal clinic takes up to 2 weeks, since in this case the time to prepare the result depends on the workload of the institution and does not require urgency.
In private clinics, an answer can be given within 1-3 days, however, it should be remembered that the most accurate result of a cytological examination can be obtained if all stages of sample preparation are followed, which takes about 7 days outside the cito ("urgent") mode.
Deciphering the results
Cytological analysis in gynecology ends with the issuance of results in the form of a cytogram.
The cytogram contains information about one of the 5 stages of the development of the disease according to the Bethesda system from 2014:
- Absence of deviations. Negative test result.
- Small changes in cell morphology; atypical cells are absent. As a rule, this stage indicates the presence of inflammation, the detection of which will require additional examination measures.
- Some cells contain deformities of the nuclei, which indicates their tendency to be atypical. The stage is characteristic of dysplasia and erosion of the cervix, requires a histological examination to exclude precancerous conditions.
- Presence of cells with malignant deformities: enlarged nucleus; altered cytoplasm; change in the structure of chromosomes. This stage indicates a precancerous level of dysplasia.
- The presence of cells with malignant changes in large numbers.
In addition to epithelial cells, the cytogram describes other components of the smear:
- the degree of microbiological purity of the vagina (the norm is 1 and 2 degrees; 3 and 4 degrees indicate infectious inflammation);
- the number of leukocytes (white blood cells that appear in a smear when different types inflammation; normal - up to 10 pieces in a smear from the surface of the cervix, up to 30 - from the urethra);
- the presence of mucus (the norm is a moderate amount);
- the presence of bacteria and fungi (microorganisms must be absent);
- the content of squamous epithelial cells (no more than 10 pieces).
Cytogram-detectable disorders
Analysis for cytology in gynecology is informative method which allows diagnosing many disorders on initial stage. In addition to varying degrees of progression of malignant processes, a cytogram helps to detect a wide range of other pathologies.
Benign formations and dysplasia (cell deformations) are dangerous with the possibility of degeneration into cancer:
- polyps- proliferation of cells;
- leukoplakia(hyperkeratosis) - deformities of the epithelium (mucous lining) of the cervix;
- erythroplakia- atrophy of the cells of the upper layer, can be observed with low estrogen;
- dysplasia- changes in the structure of cervical epithelial cells (refers to precancerous conditions).
Inflammation of a non-infectious nature (for example, caused by decompensated diabetes mellitus).
The state of the hormonal background and its deviations:
- high estrogen is an oncological risk factor for diseases of the genital organs and mammary glands;
- reduced amounts of estrogen possible reason infertility and instability of the menstrual cycle;
- increased values of androgens - male sex hormones;
- deviations in the content of prolactin;
- discrepancy between hormonal activity and the phase of the cycle.
Additional examinations that can be prescribed if 2-5 stages are detected in the cytogram:
Table 1:
| Phenomena | signs | Duration | Frequency of occurrence |
| Norm |
| 1-2 days after the procedure | Often |
| Dangerous |
| More than 3 days | Rarely |
Table 2:
| Causes | Possible consequences | Actions |
| Pass on one's own |
|
|
| Seeking urgent medical attention |
Analysis cost
Cytological examination in Russia is included in the free medical insurance program. Private services offer to carry out a test within 1000 rubles. (data for 2018), with the possibility of taking material at home.
Where can I get a smear for cytology?
An analysis for cytology in gynecology is one of the mass types of examination of the female population in Russia.
According to the compulsory health insurance program, a smear for cytology is given at the antenatal clinic at the place of residence.
Almost all private clinics in Russia offer similar services. Large institutions have their own laboratory facilities for testing samples, smaller ones send samples to intermediary centers.
Possible complications after taking a smear
The standard procedure for taking cytological material from areas up to the back of the cervical canal may be limited to slight discomfort in the cervical region, which disappear after 1-2 days. However, sometimes there are other manifestations.
Normal and dangerous complications after a cytological examination
To prevent complications after taking material for cytoanalysis, you should follow a few simple rules:
- within 1-2 days, be limited to a shower when taking water procedures;
- at least 1 week to refrain from sexual activity, douching, using a tampon and other intravaginal means.
Features of cytological examination in pregnant women
In the normal course of pregnancy, a cytological smear is taken 3 times - upon registration, at the 30th and 36th weeks. main goal research is in this case the detection of infections dangerous to the fetus, as well as the identification of atypical cells, which, subject to predisposition, first appear during pregnancy.
Contraindications to manipulation are increased uterine tone and the threat of abortion.
The life of a modern active woman includes many factors that can adversely affect her health, therefore, for the timely diagnosis of possible pathologies, it is extremely necessary to be regularly examined by specialists. Cytology analysis in gynecology is one of the most accessible, simple and effective methods early detection of violations.
Article formatting: Lozinsky Oleg
Video about cytology analysis
What is a cytology test and how is it done:
To date, the main way to examine the internal female organs is a smear for cytology, which shows the development of infections and dangerous pathologies. It differs from other types of laboratory research in a special set of dyes and fixatives, which increase the reliability of the final results.
What is a cytology smear
Cytological Papanicolaou, Pap test) is a laboratory microscopic examination of the upper ball of the cervix, designed for the timely diagnosis of cancer. This method is the most painless, simple and fastest of all. known ways examinations.
Purpose of analysis
In order to prevent and prevent the development of dangerous diseases, the cytology of a smear from the cervical canal is done to every woman. This analysis allows you to identify violations in the cellular structure of the cervix that cause the development of cancer. To avoid possible pathologies, all women should regularly visit a gynecologist. If changes occur, they are fixed at an early stage, when the disease is treatable, and full recovery is still possible.
In addition to cellular pathologies, a cytology smear allows you to evaluate the mucous membrane and determines the presence of harmful microorganisms in the vagina. The PAP test is the exact data of these parameters, so in such cases it is necessary to use additional methods of analysis.
Indications for Pap test
A smear is prescribed to all women after 18 years of age during a routine examination by a gynecologist once a year. Also indications for analysis are: violation of menstruation, the presence of papillomavirus and genital herpes, free sexual intercourse, infertility, the use of hormonal contraceptives, the establishment of an intrauterine device, pregnancy planning. Infectious diseases often also serve as a reason to take a smear for cytology. What the result shows can only be determined by a specialist.
Risk group
Regardless of age, there are certain factors that increase the risk of developing cancer. With prolonged action on the female body, they weaken immune system. This risk group includes women who have many sexual partners, smoke, have weak immunity, are carriers of viruses, have begun sexual life V early age, suffered in the past cancer of the reproductive system.
How a smear is made
To obtain reliable results, a woman should stop taking antibiotics a week before the analysis. The day before the study, you need to stop douching and put vaginal suppositories and have sexual intercourse.
A smear is taken on a chair during an examination by a gynecologist. The doctor takes 3 smears: from the walls of the vagina, from and from the mouth of the paraurethral passages. This procedure is completely painless. To take a smear, a gynecological mirror and a spatula are used. To prevent objects from being cold and not creating discomfort, they can be heated with hot water before use.
At the next stage, the doctor applies the test material to a special glass, on which a laboratory analysis of the smear for cytology will already be carried out under a microscope.
Interpretation of the results of the study
The last and most important stage of the study is the transcription of a smear for cytology. According to the analysis, the doctor can obtain information about the state of the epithelium, the presence of inflammation and the composition of the microflora. In modern medical practice, the Papanicolaou technique is widely used to decipher the results of a smear, according to which 5 stages of the development of pathologies are distinguished.
Stage 1 - there are no abnormalities, cytology is normal. This stage indicates the health of a woman.
Stage 2 - during a routine examination or in the presence of complaints, a woman takes a smear for cytology, which shows a slight change in the structure of the cells. It is caused by inflammation of the internal genital organs. This stage is also considered the norm, but more thorough research is still required to establish the causes of the disease.
Stage 3 - a small number of cells with anomalies in the structure of the nuclei were found. In this case, it is necessary to take a second smear and conduct a histological examination of the tissue.
Stage 4 - during the analysis, cells with malignant changes can be detected. For example, an increased mass of nuclei, changes in the cytoplasm and chromosomes. The result obtained is not a final diagnosis, but serves as a reason for further examination.
Stage 5 - in smears are present in large quantities.
Deciphering a smear for cytology may take some time. It usually takes a few days, but there are times when you have to wait a week for results.
The reliability of the results of the Papanicolaou method is very high, especially when a smear is examined for cervical cytology. But this analysis does not provide any information about the state of the uterus itself, ovaries and fallopian tubes. There are cases when the PAP test gives false data. Therefore, for an accurate interpretation of the results, it is necessary to undergo a comprehensive examination.
Positive results: types of pathologies
If the data obtained from the study correspond to the norms, then no deviations have been identified, and the woman is healthy. In the case of positive results, the development of pathology takes place.
The detection of abnormal cells does not always indicate the presence of cancer. Often during the Pap test, dangerous infectious diseases are detected.
1. Papillomavirus infection - the formation of genital warts in the vagina and on the cervix. This virus is very dangerous for women's health.
2. Chlamydia - the most common. Basically, this disease occurs without severe symptoms. In addition, it is difficult to diagnose it in the laboratory. This complicates treatment, and its absence threatens with serious complications.
3. Trichomoniasis is a popular sexually transmitted disease. The main symptoms of the disease: itching, yellow-green discharge, discomfort during urination and during sexual intercourse. Timely diagnosis of pathology allows you to completely cure the disease.
4. Gonorrhea - an infectious disease of the genitourinary system. The chronic form of the disease is often the cause of infertility in women.
5. A yeast infection is an overgrowth of a fungus that lives in the vagina. For some reason, its reproduction is out of control, and inflammation occurs. It is accompanied by irritation and itching, white discharge with a characteristic odor.
If the result of the smear test is positive due to the presence of an infection, the identified diseases should be treated. Very often it is difficult to determine cancer precisely because of viruses. Therefore, after a course of therapy, it is necessary to repeat the analysis in order to obtain more accurate data.
Depending on the pathology, sometimes it is necessary to take a repeated smear for cytology, which shows the dynamics of changes in the structure of cells over a certain period.
Pap smear collection during pregnancy
At the slightest suspicion of the presence of infections and fungi harmful to the fetus, cytology is often used. The inflammatory type of smear allows you to diagnose pathological processes if a woman complains of burning and itching of the external genital organs, changes in the color and smell of discharge. To analyze the state of the microflora of the vagina in pregnant women, a smear for cytology is done at least three times. If necessary, the doctor may order additional Pap tests.
The Pap test for pregnant women is carried out according to the usual technology.
Possible complications after taking a smear
Taking a smear for cytology should be done by a specialist doctor who knows the technique of this process. After performing a Pap test, some complications are possible. Most often they are manifested by severe pain after manipulation and bloody discharge during the day or a little longer. These symptoms are considered quite normal and do not require treatment. If after the study there are severe pain in the abdomen, fever and chills, you need to see a doctor.
Cytology with improper sampling also sometimes has dangerous consequences. With gross intervention, stenosis provoked by adhesions can develop. For this reason, it is not customary to take a prophylactic smear in deep places of the cervical canal.
Within a week after the Pap test, intimate relationships, douching and the use of tampons should be abandoned.
The cytological smear is considered best method detection of cervical cancer in the early stages of development. But even the best laboratories sometimes fail to detect cellular changes. Therefore, for a greater likelihood of detecting pathology, you need to take a smear annually.
Cervical tests are one of the main methods for diagnosing the condition of the female genital organs. Many pathologies of the cervix are often asymptomatic, but can lead to very serious diseases. Therefore, timely diagnosis of diseases is very important to prevent the development of serious diseases of the female genital area.
The main laboratory tests are a cytological analysis of the cervix and an analysis for a biopsy of the cervix.
Cytological analysis of the cervix
A cytology smear (PAP test, Pap smear) is a cheap, simple and fairly accurate method of gynecological examination that allows you to determine the condition of the tissues of the cervix. With the help of a cytological smear, it is possible to identify abnormal (atypical) cells that can degenerate into malignant ones. A smear is an absolutely safe and painless procedure.
Indications for analysis
Experts recommend that all women begin to take a cytological analysis of the cervix three years after the onset of sexual activity, but in any case no later than 21 years. Women aged 21–49 years should have this examination every three years, and women aged 50–65 years should have it once every five years.
Cytology analysis is the most affordable and in a simple way diagnosing cervical cancer and dysplasia (precancerous conditions). Regular conduct of such a study is necessary for women suffering from the human papillomavirus or genital warts. This is due to the fact that these diseases most often provoke the development of cervical cancer.
Preparation for analysis
Firstly, a smear is not taken during menstruation and in the first few days after it ends, with inflammatory diseases of an infectious nature. Secondly, two days before the analysis, it is necessary to stop using vaginal tablets, suppositories, sprays, douching, and intimate hygiene products. Thirdly, you need to give up sexual intercourse two days before the study.
Conducting an analysis
A smear for cytology is taken during the examination of a woman in gynecological chair. First, the doctor, using a cotton swab, cleans the surface of the cervix from secretions. After that, using a special brush, material for analysis is taken, which is applied to a glass slide. The glass is then sent to a laboratory where it is examined under a microscope. Typically, test results are ready within 1-2 weeks.
Often, simultaneously with a cytological smear, the doctor takes the material for bacteriological analysis, with the help of which the microflora of the cervix and vagina is determined.
Normally, a woman may experience slight dirty green or dark brown discharge within 3-5 days after the test. This condition does not require any treatment. For 7-10 days after the cervical test, a woman is not recommended to have sex, douche and use vaginal tampons.
results
The results of a cervical smear analysis for cytology are normal (“negative”, “good”) when they indicate the absence of serious changes in the cervical mucosa. Pathological smear results (“positive”, “poor”, “dysplasia”, “atypia”) indicate that changes have been detected that can lead to the development of cancer.
There are many factors that can cause a change in the state of the cervical epithelial cells. The most common cause is the human papillomavirus and many other sexually transmitted infections (ureaplasmosis, chlamydia).
But do not take poor smear results as a sentence. If abnormalities are detected, the doctor will prescribe additional studies, usually a colposcopy (examination with a colposcope). After that, if necessary, the patient is assigned an additional study - a biopsy of the cervix.
A biopsy of the cervix is the cutting (excision) of a piece of cervical tissue for microscopic examination. A biopsy can be diagnostic (performed to establish or clarify the diagnosis) and therapeutic (performed to monitor changes in tissues during therapy).
Conducting an analysis
Analysis of the cervix with a biopsy is more accurate than a cytological examination. Using a colposcope, the doctor finds pathological areas on the cervical mucosa and takes material from them for analysis. With the help of a biopsy, you can find out exactly whether atypical cells are pathological, and how much the changes have manifested themselves. Thanks to this study, the specialist selects the necessary method of treating the patient.
A biopsy of the cervix can be done in the following ways:
- pinched - made with special biopsy forceps; wound healing occurs within 3-4 days; less traumatic and quite informative way;
- radio wave (loop) - produced by a radio wave loop; absolutely bloodless method at the time of material sampling; slight spotting occurs a week after the biopsy;
- conization - excision of a tissue fragment in the form of a cone; is used not only for diagnosis, but also for the removal of the pathological part of the cervix.
For each individual patient best way biopsy is selected by the doctor. This procedure is carried out 3-5 days after the end of menstruation. Before a biopsy, a woman is sent for blood tests for HIV infection, hepatitis, syphilis.
Analysis of the cervix for a biopsy is performed on an outpatient basis or in a hospital. Since this procedure is often performed under anesthesia, it is not recommended to eat food 12 hours before the procedure.
The material is taken from a woman lying on a gynecological chair. After the biopsy, the doctor treats the wound surface with a special coagulant solution that accelerates blood clotting. The results of this analysis are usually ready for 10-14 days.
Consequences
After a biopsy, a woman may have pulling pains in the lower abdomen for five days, and spotting discharge may be observed for ten days.
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