Cytology in gynecology. The study of smears for cytology of the cervix: transcript. Analysis for oncocytology: how is a cytological analysis performed during pregnancy

It is not always possible to diagnose a disease of the genital organs in women. Especially when it comes to the initial stages of the disease. As a result, valuable time needed for successful treatment is wasted. The development of oncology in most cases is asymptomatic. It is impossible to know about the presence of cancer without a special examination. One of the methods to reliably determine the development of cancer cells in the early stages is the analysis of cytology.

What does a gynecological examination show?

Cytology in gynecology is one of the ways to study cellular material. The gynecologist collects a smear from the cervix and cervical canal to find or exclude pathological cells, dysplasia.

The most important study in gynecology is the analysis of a smear from the cervical canal.

The test is carried out under a powerful microscope and makes it possible to recognize atypical cells in a timely manner, showing their shape, size and location.

When deciphering the test, the number of epithelial cells is indicated as a percentage. The classification of the results most often occurs according to the Papanicolaou method. Only cells with a pictonic nucleus are taken into account. Changes in the tissues of the neck according to the standard method are divided into several types:

2, 3, 4 stages of changes may indicate the presence of some sexual diseases, namely:

vaginitis;
genital herpes;
candidiasis;
papillomavirus.

You need to understand that this study shows the existing inflammation, genital infections, but does not determine the cause that caused them.

Analysis results

The test must be interpreted by a qualified medical professional. The information found on the Internet is for guidance only and is inaccurate.

What data does the analysis result contain:

In addition, you need to remember some features of the cytology study:

The test is reliable in 90% of cases. Therefore, it can be carried out in a year or two. Repeating the procedure is necessary to completely eliminate the risk of the disease.
2% of all smears are non-informative due to the lack of test materials.
Not always detected pathological changes in the smear indicate the presence of an oncological disease.
A woman cannot be definitively diagnosed on the basis of a Pap test alone.

The interpretation of the results can be performed using various methods. In modern gynecology, along with the PAP test, other interpretation options are also taken into account, for example, the Bethesda system.

In cytology, a result is considered normal in which there are no changes in the cellular material. Healthy cells must meet certain standards for shape and size.

In addition, the analysis of a healthy woman must meet certain requirements:

The cells of the cervix consist of a single layer of cylindrical epithelium. Stratified epithelium is acceptable in a vaginal smear.
No pathological changes were found in the stratified epithelium.
The number of leukocytes does not exceed 15 units.

Sometimes the results show the presence of benign cellular material. The situation is not considered normal, but is not a cause for great concern due to oncology.

Indications for the procedure and preparation for it

Indications for histology analysis are obesity and diabetes mellitus. Women over the age of 40 are recommended to have a test at least once a year.

To maximize the reliability of the result, before going to the gynecologist, you must follow the following instructions:

Refuse to take topical drugs, such as suppositories and vaginal tampons.
Do not perform the procedure during menstruation, as well as in inflammatory diseases with a strong secretion. A smear is done only after complete recovery.
Do not go to the toilet a few hours before taking the material.
2 days before the analysis, you should refrain from sexual activity.
Do not douche.

These simple rules will avoid repeated visits to the gynecologist. Smear sampling lasts no more than 15 minutes, along with an examination by a gynecologist. The procedure is carried out in this way:

The reaction of the biological material and the dye allows us to conclude that it is possible to develop an oncological disease. If the test was carried out taking into account all the requirements, then the study of the material will take 7-8 days. The woman will be able to find out about the test results from the attending physician 2 weeks after the procedure. If the analysis was carried out in the cito mode, then the indicators will be known in a few days.

The main advantages and disadvantages of the method

The main advantages of this method of diagnosing cancerous tumors include:

availability of the necessary biomaterial for research;
safe and painless getting it;
diagnosis at the very first stages of the appearance of cellular changes;
obtaining additional information about the presence of various pathologies;
the possibility of studying deviations in dynamics;
affordable analysis price.

In addition to the advantages, there are also a number of disadvantages. The main disadvantages of oncocytology are:

the possibility of obtaining an unreliable result in the case of poor-quality collected material;
insufficient information about the present tumor due to the study of cells, not tissues;
the impossibility of diagnosing certain types of oncological formations.

Modern methods and methods of diagnosing cancerous tumors make it possible to detect pathology at the earliest stages. It is only necessary to pass the necessary and recommended examinations in a timely manner for effective and efficient therapy if abnormalities are detected.

What is a cytological study? In what cases is it carried out? You will get answers to these and other questions in this article.

A cytological study is the study of the structural features of cells, the cellular composition of tissues, fluids and organs of the human body in normal and pathological processes using a microscope. The purpose of the study is to determine the type of fixed lesions, their benign or malignant nature.

Cytology and histology - what is the difference?

The difference between cytological analysis and histological examination is that cells are studied, not tissue sections. This means that the final conclusions are made on the basis of changes that have occurred in the nucleus, cytoplasm, nuclear-cytoplasmic ratio, the formation of complexes and cell structures.

When is a cytology test done?

Cytological examination is used for:

Preventive examination (screening)
Clarification or establishment of the diagnosis of the disease
Clarification or diagnosis during the operation
Control during and after treatment
Observation of process dynamics or for early detection of pathological changes

What materials are used for analysis

Liquids

These can be liquid samples:

urine, sputum, or prostate juice
cerebrospinal and amniotic fluid
swabs from various organs taken during endoscopy
smears of the cervix and smears of the uterine cavity (cytological examination of smears, cytological examination of the cervix)
secretions from the mammary glands
scrapings and impressions from eroded or ulcerated surfaces, fistulas or wounds
fluids from articular and serous cavities

Punctates

These include materials obtained by aspiration diagnostic puncture, which is performed using a special thin needle.

imprints

In this case, we are talking about prints from removed tissues, such as from a fresh tissue incision surface removed during surgery or taken for further histological examination.

Appointment of a cytological study

The main purpose of the cytological method of research is to obtain an answer to the question of the absence or presence of a malignant neoplasm in a patient whose material has been studied. This method allows you to more accurately determine the nature of the pathological process (benign and malignant tumors), the nature of inflammatory, proliferative, reactive and precancerous lesions.

It is the detailed morphological characteristics of the detected neoplasm that makes it possible to choose the most reasonable method of treatment. whether it is surgical removal of the neoplasm, radiation therapy, chemotherapy or a combination of them, depending on the structure of the tumor, its origin, the degree of atypia of its cells and the possible response to treatment.

Cytological examination, in comparison with other methods, has undeniable advantages in identifying the initial stages of cancer. This research method is used in the diagnosis of neoplasms in almost any of the tissues and any organ of the human body. Thanks to a cytological examination, it is possible to detect stomach cancer, lung cancer, and other organs, even in the absence of radiological, clinical and endoscopic manifestations and signs.

Cytological analysis in gynecology

A smear for cytology is taken on an outpatient basis during a gynecological examination. Normally, it is recommended to carry out such an analysis once a year, when you undergo a preventive examination by a doctor. An additional cytological examination may be prescribed in cases where:

there are inflammatory diseases in which there is a suspicion of the presence of a urogenital infection
in the study of the causes of infertility
there are complaints about menstrual irregularities
it is required to determine the nature of changes due to prolonged use of hormonal contraception
when planning a pregnancy
operative gynecological intervention is planned (curettage, installation of an intrauterine device, etc.).

Carrying out cytological analysis in gynecology

It is best if the material is taken on the 10-11th day of the menstrual cycle. 2 days before the procedure, you should refrain from sexual intercourse, douching, use of contraceptives or local medications. You should also not urinate for about 2 hours before the procedure.

Scraping (material sampling) from the cervix is performed using a special sterile brush, after the doctor inserts the gynecological mirror and fixes the cervix. As a rule, this is done twice - from a place located closer to the uterus and then to the vulva. The resulting material is applied to a glass slide, dried and fixed using special solutions. Often, in order to speed up the process of obtaining a result, women themselves deliver the material to the laboratory for research.

The procedure itself is completely painless and very fast - no more than 10-15 seconds. After it, sometimes there may be a slight spotting, which disappears within a day. This usually happens when a woman has any inflammatory processes.

One of the most informative methods of early diagnosis is the analysis of cytology in gynecology. What is this procedure and why is it needed, every woman of reproductive age who is sexually active should know. Despite the possibility of using the latest technological equipment, cytological examination is still a popular diagnostic method in gynecological practice.

What is the essence of the method?

When visiting a gynecological office, a woman often hears the phrase “a smear for cytology”. What kind of study is this and in what cases is it shown?

The essence of cytological analysis is to identify atypical (oncological) cells in the collected material. The method consists in examining the structure, shape of cells, the size of the nucleus, and their changes under a microscope. This inexpensive type of diagnostics is carried out in any medical institution.

In addition to identifying atypical cells that may indicate an incipient cancer, a cytological examination is used for preventive examinations in women over 18 years of age who are sexually active. Cytological analysis is also considered as an auxiliary method in clarifying the diagnosis, determining the effectiveness of the prescribed treatment. The sampling of cellular material is also carried out during surgical intervention, when it is necessary to assess the nature of the neoplasms.

The standard procedure is to take a smear for further examination for cytology in the laboratory. During a gynecological examination, the doctor visually examines the vaginal area, cervix and cervical canal using mirrors. With a pronounced inflammatory process or if atypia is suspected, a more thorough examination will be required.

Cells for research are taken not only from vaginal secretions. The following biomaterials can be used for cytological analysis:

secretions of the mammary glands;
urine;
any biological fluid (including amniotic);
a tissue sample obtained by puncture of an organ;

The accuracy of the result is affected not only by the quality of the collected material, but also by the human factor. If the procedure is performed in accordance with the requirements in compliance with the rules of storage and transportation, then the result of the analysis will be as informative as possible. During sampling, it is important to take material from several areas of the affected area. This will determine the extent of the spread of the pathological process and detect atypia.

In the gynecological practice of Western countries, this diagnostic method is called the PAP test, or the Papanicolaou test.

The PAP test is indicated not only in case of suspicion of an oncological process, but also in the diagnosis of various infectious and inflammatory processes in the reproductive organs.

The duration of the sampling procedure is no more than 10 seconds. Further cytological examination is carried out in the laboratory by laboratory assistants or automatic systems.

Analysis is of two types:

standard (research takes no more than 3 days);
urgent (carried out during the period of surgical intervention in order to determine further tactics of action, takes no more than 10 minutes).

How is material collected for research?

The sampling of cellular material is an almost painless procedure. With a small brush, which is part of the individual gynecological kit, the doctor takes a swab from the inner and outer surface of the cervix. If the gynecologist makes a scraping of a tissue fragment, then the patient may feel an unpleasant tingling sensation. From the resulting wound, slight bleeding may occur within 1-2 days.

Before the procedure, you must adhere to the following recommendations:

restriction of sexual activity for 1-2 days before the expected date of the smear;
refusal to use vaginal contraceptives and other topical medicines;
when using any systemic drugs, it is necessary to inform the doctor about it;
refusal to douche;
before the procedure, a regular toilet of the intimate area without the use of flavored hygiene products is sufficient;
It is not recommended to urinate 1-2 hours before the proposed manipulation.

The procedure for taking a smear is carried out only after the complete cessation of menstrual flow, usually on the 5th-7th day of the cycle. The period of ovulation occurring in the middle of the menstrual cycle (13-14 days) is not suitable for analysis. Acute infectious and inflammatory diseases are also a contraindication to taking the material. In this case, the diagnosis is carried out after the elimination of the clinical manifestations of the disease.

In most cases, the sampling of cellular material for cytology occurs without any complications.

Indications for a Pap smear:

inflammatory processes in the vagina, cervix and cervical canal;
infection with the human papillomavirus (especially HPV 16, 18 due to oncogenic activity);
pregnancy planning;
herpesvirus infection;
primary or secondary infertility;
the use of systemic hormonal contraceptives;
violation of the menstrual cycle (change in the nature of the discharge);
feeling of physical discomfort during sexual intercourse;
the establishment of an intrauterine contraceptive (spiral);
existing oncological diseases of the reproductive sphere in maternal relatives;
the period after surgery or in the treatment of erosion, dysplasia, cervical cancer.

Analysis result interpretation

The analysis for cytology in gynecology is deciphered by the doctor and explains to the patient what it is.

The method for detecting atypical (cancerous) cells, developed in the middle of the last century, is now used to diagnose precancerous conditions. Even a slight deviation from the normal values is a reason for re-analysis. A control examination, carried out every 3 months, will allow timely stopping the progression of the pathological process, the germination of atypical cells in the deeper layers.

The cytological classification developed by Papanicolaou still serves as an indicator of pathology.

1 class. It is characterized by the absence of atypical cells and is the most favorable option.
Grade 2 In this case, a developing inflammatory process with structural cell disorders is diagnosed.
Grade 3 It is characterized by the presence of single atypical cells with an altered shape and structure of nuclei and cytoplasm.
4th grade. The presence of a small number of atypical cells suspicious of oncology.
Grade 5 There are clear signs of developing cancer.

Gynecologists consider grades 1 and 2 as background diseases and treat them with antibacterial, antifungal, anti-inflammatory drugs. Grade 3 requires further histological examination (biopsy of a tissue fragment) and the use of colposcopy.

Cytological studies, often prescribed by doctors in gynecology, are carried out simultaneously with a microbiological examination of vaginal secretions for flora. Comprehensive diagnostics helps not only to identify atypia, but also to prescribe an effective treatment for existing infectious diseases. Information about the presence of pathogenic microorganisms, as well as "wrong" cells, is present in the form of the result of the analysis.

A cytology test can be done in a public health laboratory or in a private clinic. This issue is best discussed with the attending gynecologist.

The word "cito!", which is sometimes written by a doctor on a referral for analysis, should not frighten patients. It means in Latin "urgent!" and has nothing to do with cytology. The need for urgent analysis may be due to various circumstances.

Cytology plays an important role in gynecology. Based on this study, the doctor determines further treatment tactics. An oncological disease detected at an early stage of development is much easier to overcome.

Regular preventive examinations by a gynecologist should become the norm for every woman over the age of 18.

The number of diseases of the female reproductive system is increasing every time. When a woman visits a gynecologist, the doctor takes to determine the nature of the microflora. To determine oncological diseases, a smear is taken for cytology. All women need to be tested once a year.

Cytology smear: description and significance of the procedure

Pap smear for cytology - diagnosis of changes in the cells of the cervix and vagina

Cytological examination is a highly informative and reliable diagnostic method, thanks to which you can get information about the condition and possible changes in.

A cytological smear or Pap smear is a microscopic examination that helps to identify possible pathologies of the cervix. This is a simple, painless procedure. For study, cells are taken from the surface of the neck. This non-invasive diagnostic method allows you to identify the pathogens of some.

With the help of a cytological examination, atypical cells can be identified, indicating dysplasia. Under dysplasia, it is customary to understand a change in the structure of all layers of the cervical epithelium. This disease can lead to the development of a tumor of the cervix.

This study is mandatory for diagnosing possible changes in the structure of the cervix, as well as choosing an effective method of treatment.

Usually, a malignant process begins to develop from the lower layers of the epithelium. It progresses over time. As a result, if a scraping was taken from the surface layer, then a diagnosis can be made when the disease is at its last stage.

Unlike a histological study, during which a single tissue sample is studied, all cells used by the cervix are taken for a cytological examination. When a precancerous condition is detected, invasive research methods are prescribed to clarify the diagnosis.

Purpose of analysis

Taking a smear for cytology is carried out in the following cases:

Planned pregnancy
Cervical erosion
Vaginal discharge
irregular periods
warts
Herpetic eruptions in the vagina
Change of sexual partners
Obesity

A cytological examination is prescribed before installing an intrauterine device, as well as with prolonged use of hormonal drugs.For prevention, women should take a smear for cytology every year. The study is prescribed as soon as the girl begins to live sexually.

Procedure: preparation and execution

A smear for a cytological examination should be taken after the end of menstruation. The procedure is not carried out with inflammatory processes in the body and during menstruation. If a woman underwent a gynecological examination or colposcopy, then the Pap test is performed no earlier than 2 days after these manipulations.

2 days before the study, it is necessary to exclude sexual activity, you can not douche and use vaginal suppositories and creams.

The procedure for taking a smear for cytological examination is as follows:

the woman is located in the gynecological chair and the gynecologist inserts a special into the vagina to access the cervical canal
take with a special spatula or cytological brush from the cervical canal, into the vagina and
after the examination, the doctor takes a smear exactly on the suspicious and inflamed area
then the material is applied to a glass slide and sent to the laboratory.

The duration of the procedure does not exceed 15 minutes along with a gynecological examination.The laboratory assistant stains the obtained material according to the Papanicolaou method. Based on the reaction of cells with dyes, a conclusion is made about a possible inflammatory process or a precancerous condition.

In addition to the PAP test, liquid cytological testing is carried out.

The decoding here is deeper: they are placed in a special solution, where they are examined under a microscope. Carrying out a liquid simultaneously with a conventional smear for cytology allows you to achieve reliable results.

An interesting video - Cytological studies in gynecology.

After a smear, in rare cases, a woman experiences discomfort. Sometimes after the procedure, there may be spotting and soreness in the lower abdomen. These symptoms go away after a few hours. In these cases, you should use personal hygiene products. To avoid pain and discomfort, you should give up sexual activity for a while.

However, if after taking the smear, spotting, abdominal pain, fever, you should immediately call an ambulance. Such a reaction can occur with an incorrectly performed scraping or a running inflammatory process of the mucous membrane.

How much is a smear and decoding of the results

The study is performed under a microscope and the results can be obtained 1 day after taking a smear. During the study, the shape and size of the cells are determined, and on the basis of this, a precancerous or cancerous condition can be diagnosed. If poor quality is obtained, then the sampling of material for research must be repeated.

Pap smear results:

At the first stage of the Pap test, the result is negative. Normally, there are no abnormal cells.
Subsequent stages are assessed as positive. At the second stage, morphological changes in cells and an inflammatory process are observed. This stage requires careful conduct to identify the causes of inflammation. Usually detected.
At stage 3, single epithelial cells with anomalies in the structure are found. Some cells have enlarged nuclei, which indicates development. In the future, this can lead to a malignant process. In this case, the woman must take a second smear, take a biopsy and undergo a histological examination. The diagnosis is made only after an additional examination.
Stage 4 requires urgent. The smear reveals cells that resemble malignant ones. An additional examination involves a colposcopy and biopsy with the collection of a suspicious area.
At stage 5, a large number of cancer cells are found in the smear and this indicates an oncological disease. A woman should urgently contact an oncologist for further treatment.

It should be remembered that on the basis of a cytology smear, it is impossible to draw a conclusion about the state of the uterus or. Therefore, it is recommended to pass.With the constant passage of a preventive examination and taking a smear for a cytological examination, the likelihood of developing serious diseases is significantly reduced.