Oncocytology transcript. Detailed explanation of smear analysis for flora in women

According to statistics, cervical cancer is given one of the leading places among malignant oncological pathologies in patients. Prevalence rate: 20 women out of 100,000. The age group most at risk is from 35 to 60 years old; in girls under 20 years old the disease is extremely rare. A smear for oncocytology will allow you to diagnose this disease at an early stage.

As a rule, with local cervical cancer, more than 80% of women live more than 5 years, and in the presence of metastases, this figure does not exceed 13%. It is important to carry out annual monitoring and get tested for oncocytology on time. Timely screening, identification of precancerous and cancerous conditions, as well as adequate treatment tactics will help to avoid loss of ability to work, disability and death.

Oncocytological diagnosis is the examination of a smear under a microscope by a doctor to diagnose the presence or absence of pathological changes mucosal epithelial cells. A smear for oncocytology of the cervix is ​​prescribed to all girls over 18 years of age at least once a year.

Why do you need a smear for oncocytology?

A procedure for the purpose of assessing the condition of the mucous membrane of the cervix, identifying the inflammatory process, as well as for timely detection of the formation of pre-tumor or tumor cells.

If according to the data laboratory diagnostics If the presence of an infectious agent of a viral, bacterial or protozoal nature has been established, then a smear for oncocytology is important to determine the body’s response to their presence. Besides, this method allows you to identify signs of proliferation, metaplasia or other modification epithelial tissue.

In addition, a smear for cervical cancer also allows you to identify factors that contribute to changes in epithelial tissue, among them:

• pathogenic microflora;
• exacerbation of the inflammatory process;
• pathological reactions of the body to taking hormonal and other medications;
• development of dysplasia.

Such a wide list of indicators that can be established with this type of diagnosis makes it possible to classify it as one of the most important in identifying visible pathological conditions of the mucous membranes on the cervix, as well as in a comprehensive screening examination.

Varieties

Currently, there are 3 main varieties:

• cytological diagnosis with Leishman staining is the most common type, which is most often used in public antenatal clinics;
• The Pap test (Papanicolaou smear) is widely used in private laboratories and abroad. It is believed that the level of reliability of this type of diagnosis significantly exceeds the previous one. The analysis mechanism differs in the degree of complexity of staining the smear;
• Liquid cytology is one of the most modern diagnostic methods, equipment for which is available in a few laboratories. It occupies a leading position in terms of information content and reliability. With this type of smear for oncocytology, the biomaterial is introduced into a special liquid medium for research. After which the cells are purified and concentrated, forming a thin, even coating. The mucous epithelium prepared in this way is not dried when transported to the laboratory for microscopy, which significantly increases the accuracy of the data obtained.

Analysis for oncocytology of the cervix

The procedure for taking a smear for oncocytology is completely painless and does not cause any discomfort. This is a standard procedure when visiting a gynecologist. The algorithm for taking a smear for oncocytology consists of the following steps:

• insertion of a speculum into the vagina;
• collecting biomaterial (smear; scraping) with a special spatula or cytobrush;
• additional collection of cell samples from cervical canal with a cotton swab.

The taken biomaterial is spread evenly in a thin layer over the glass slide. The specimen is then stained with Leishman or Papanicolaou and then examined in detail under a microscope. In the case of liquid-based cytology, the glass slide is first placed in a special liquid.

In rare cases, taking a smear for oncocytology is accompanied by subsequent not abundant bloody discharge, lasting no more than 2 days. Such manifestations are normal and do not require seeing a doctor.

Important: inflammatory processes internal genital organs are a limitation for this type of analysis.

This fact is due to the possibility of obtaining distorted and unreliable results, which will entail an incorrect diagnosis and prescription improper treatment. Therefore, the cause of the inflammatory process in the body is first diagnosed, followed by its relief. Only after this is it possible to cytologically examine the cervix.

How long does it take to prepare a smear for oncocytology?

The duration of cytogram preparation varies from 3 days to 2 weeks, not counting the day of taking the biomaterial, depending on the workload of the laboratory. In private clinics, results are usually provided within 3-4 working days. Ready results of liquid cytology are issued within 10-14 days.

Oncocytology smear - interpretation and normal values

Analysis of the mucous epithelium located on the cervix is ​​extremely informative for the practicing physician. However, often the gynecologist does not issue full transcript each patient individually.

Normal values ​​typical for healthy patients are presented in the table.

Indicators	Normal values
	V	WITH	U
Leukocytes	0-10	0-30	0-5
Flat epithelium	5-10
Gonococci	—	—	—
Trichomonas	—	—	—
Key cells	—	—	—
Yeast	—	—	—
Microflora	The predominant number of gram-positive Dederlein rods	—	—
Slime	Moderate amount	Moderate amount	—

When is it possible to get erroneous results?

This situation is possible:

• in young girls under the age of 20 against the background of global hormonal changes that affect and modify the mucous epithelium;
• material for the study was collected during menstruation. In this case, the finished drug is represented by a predominant number of endometrium and blood;
• contamination of the finished product (sperm, medications, suppositories or cream, as well as lubricant for ultrasound);
• if the patient underwent a bimanual vaginal examination, due to which talc from the gloves remained on the cervix;
• in case of ignoring the standards and rules for collecting biomaterial;
• due to improper preparation and coloring of the finished product.

When and how often should I have a smear for oncocytology?

Starting from the age of 18, every girl must undergo this type diagnostics The frequency of analysis increases for women who are at risk:

• age exceeds 35 years;
• abuse of tobacco smoking, psychotropic drugs and alcohol;
• long-term use of oral contraceptives;
• girls who had sexual intercourse very early;
• frequent change of partner;
• positive HIV and HPV status;
• STD;
• when identifying erosion or endometriosis;
• often recurrent inflammatory diseases pelvic organs;
• often recurrent genital herpes or cytomegalovirus infection;
• identification of oncological episodes in the pedigree;
• in case of failure menstrual cycle.

Oncocytology for pregnant women

During pregnancy, the frequency of analysis can increase up to three times. This fact is due to the need early detection pathological processes which may pose a threat to mother and child.

Important: the procedure is performed only if the pregnancy is normal and the patient is in complete health.

If pathological conditions are detected, the study is postponed until complete recovery.

If the biomaterial collection technique is implemented correctly, the procedure does not harm the woman, is painless and does not affect the course of pregnancy.

Oncocytology for older women

It is a mistake to believe that postmenopausal women have a reduced risk of getting sick. gynecological diseases. Oncology affects people at any age. Moreover, in the background concomitant diseases the risk of pathologies of the internal genital organs increases. That is why women over 55 years of age are recommended to undergo this test at least twice a year.

The procedure for collecting material for research and the algorithm for conducting the research itself is similar to that for young girls. This does not cause any discomfort or pain to elderly patients. Timely diagnosis any pathological condition will allow you to start treatment as early as possible, achieving maximum favorable outcomes, until complete recovery.

Summarizing

To summarize, it is worth emphasizing the following important points:

• It is recommended to conduct the study at least 5 days after the start of the menstrual cycle, and also no later than 5 days before the expected start;
• before taking a smear, you must abstain from sexual intercourse for at least 1 day, and from lubricants, tampons, douching procedures, the use of medicated suppositories and spermicidal preparations - 2 days before;
• in the presence of acute infectious process it is necessary to stop it first, and then take a control test at least after 2 months;
• false negative results and erroneous classification of the studied material as class 1 are allowed, which is why it is important to conduct a control examination annually.

Certified specialist, in 2014 she graduated with honors from the Orenburg State University with a degree in microbiologist. Graduate of the graduate school of the Federal State Budgetary Educational Institution of Higher Education Orenburg State Agrarian University.

In 2015 At the Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences, she completed advanced training in the additional professional program “Bacteriology”.

Laureate all-Russian competition for the best scientific work in the category "Biological Sciences" 2017.

Modern woman should visit a gynecologist once a year. This is necessary so that if there is a danger of any violation, measures can be taken in a timely manner. After all, any disease, the earlier it is detected, the faster it is treated. For this purpose, the doctor antenatal clinic during examination, takes a smear - biological material for oncocytology, the decoding and results of which will indicate in due time whether there is cause for concern.

Oncocytology of the cervix

Oncocytology of the cervix is ​​carried out in girls upon reaching puberty annually, when she visits the gynecological office.

Unscheduled analysis shows:

• in case of menstrual irregularities;
• when you have pain in the lower abdomen;
• after treatment with hormones;
• women before cauterization of erosion or those predisposed to the papilloma virus;
• at genetic predisposition when there are cancer patients among close relatives.

If there were ruptures or damage to the cervix during childbirth, such an analysis is recommended to be done twice a year.

Oncocytology of the cervix is ​​painless and does not create any discomfort. It is quite informative because it helps to identify atypical (cancerous) cells and diseases after analysis for oncocytology of the cervix and interpretation by a cytologist.

Indications for oncocytology of the cervix

Carrying out oncocytology - smear

In order for oncocytology of the cervix and its interpretation to give an informative result, a smear should be done immediately after the end of menstruation or before it begins.

Contraindications to the procedure

This analysis is not carried out in case of inflammation in the uterus or vagina, since the presence of microbes that caused existing illness, will distort the picture and make decoding difficult. Don't contribute normal analysis And bloody issues.

Any bleeding from the genital organs delays the collection of epithelium from the cervix (smear) until it is completed.

Also, with oncocytology, decoding becomes difficult if the simple rules preparation for it:

• on the eve of a visit to the gynecologist, do not use tampons;
• abstain from sexual intercourse two days before the procedure;
• do not douche;
• do not use funds intimate hygiene(gels, ointments, etc.);
• a couple of days before visiting the antenatal clinic, it is better to take a shower and refrain from taking a bath.

How the analysis is performed

The epithelium is collected, or more simply put, a smear is made from the cervical canal and the outer part that extends into the vagina using a special brush, tassel and spatula.

The smear examined during oncocytology of the cervix can be:

• simple, when the mucous material is distributed over the glass, fixed with the required solution, stained and then studied;
• liquid, where a brush with cells is placed in a special medium. This type of smear is new and not yet used in all laboratories.

How to properly take a smear test for cervical oncocytology

Decoding the result is normal

The results of oncocytology of the cervix and their interpretation are obtained after examining the biomaterial under a microscope. In this case, it is possible to detect both atypical and mutation cells, as well as pathogens of sexual diseases: candida fungus, trichomonas, cocci, papilloma virus.

Upon completion of the study of oncocytology, five classes are distinguished in deciphering the results:

• 1 – there is no pathological flora, no pathogenic bacteria, no viruses, no Candida mycelium, epithelial cells not changed. This smear for oncocytology is normal;
• 2 – signs of inflammation were found in the cervix (colpitis);
• 3 – the cytologist recorded a small number of atypical cells, which requires repeated analysis;
• 4 – the smear contains modified cells;
• 5 – everything in the smear is atypical and the risk of getting cancer is high. But it should be remembered that in this case, after examining oncocytology, the interpretation of the analysis only indicates the presence of unusual formations, and does not confirm the fact of oncology. That is, a certain alertness arises, and additional examinations are required, for example, colposcopy, in order to examine in detail all areas of the cervix. And also a biopsy, when a small piece of tissue is taken from a suspicious area for thorough examination.

Conclusion

For every woman, oncocytology is considered mandatory. This is especially true for older ladies who, with the advent of menopause, believe that their women's problems are already over and you don’t have to think about going to the hospital. But age is not a problem for cancer, and genital cancer is not at all the least important among other diseases. And it is precisely at this period of life, when women’s problems fade into the background, that the risk of missing the onset of the disease increases. Therefore, a study such as oncocytology and its interpretation is relevant throughout life and, in order to avoid big problems, undergo a medical examination on time.

For some reason, everyone thinks that oncocytology concerns exclusively the female genital area (cervix, cervical canal). This is probably because the condition of the cervix is ​​the subject of daily study by any cytologist, while a smear for oncocytology can be applied to the glass after scraping or fine-needle aspiration biopsy (FNA) from other places. In addition, you can make smears of the mucous membrane of the larynx, nasopharynx, skin (melanoma), and soft tissues. In principle, if an oncological process is suspected, material for research can be obtained from any place, albeit using different methods. For example, using fine needle aspiration biopsy. Most often this is done if there are doubts regarding the health of the dairy or thyroid gland where cytological diagnostics plays main role, because histological verification is provided only during surgical intervention(urgent histology) and after organ removal.

Oncocytology

Oncocytology involves microscopic analysis (study of the cellular composition and state of cell organelles) of material suspicious of an oncological process and taken from any accessible place.

In this regard, patients should not be surprised by smears for oncocytology, prepared not only from scrapings of the female genital organs, but also fine-needle aspiration biopsy(TAB):

• Enlarged regional lymph nodes (cancer of the larynx, nasal cavities and paranasal sinuses, salivary glands, penile cancer, eye tumors, etc.);
• Tumors of the pancreas, liver, gallbladder and extrahepatic bile ducts;
• Seals and nodes of the mammary and thyroid glands.

Identification and diagnosis malignant neoplasm soft tissues, skin, lips, mucous membranes of the mouth and nose, cancer of the direct or colon, bone tumors often begin with the examination of smears-imprints. And then FNA of the changed lymph nodes and/or histological diagnosis (histology) is added. For example, if a tumor of the rectum or colon is suspected, cytology is the first stage of diagnosis, but cannot replace histology.

It should be noted that some organs are not subjected to histological analysis until surgery, after all, you can’t cut off a piece of fabric in a dairy or thyroid gland and send for research. In such cases, the main hope is in cytology, and here it is important not to make a mistake and not create the risk of removing an organ that could be saved by other methods.

A smear for oncocytology during a preventive gynecological examination or to identify oncological pathology ( squamous cell carcinoma vulva, cervix and vagina) is taken by a gynecologist or midwife, applied to a glass slide and transferred to the cytology laboratory for staining (according to Romanovsky-Giemsa, Pappenheim, Papanicolaou) and examination. It will take no more than an hour to prepare the drug (the smear must first be dried and then painted). Viewing will also take no more time if the drugs are of high quality. In short, for cytology you need glasses, paint prepared in advance, immersion oil, a good microscope, eyes and the knowledge of a doctor.

The analysis is performed by a cytologist, but in other cases, smears during screening after medical examinations are entrusted to an experienced laboratory assistant who is well acquainted with variants of the norm (norm – cytogram without features). However, the slightest doubt is the basis for transferring the smear to a doctor, who will take final decision(will refer you to a specialist, offer histological examination, if possible). TO gynecological smears We will return to oncocytology a little lower, but for now I would like to introduce the reader to what oncocytology is in general and how it differs from histology.

Cytology and histology – one science or different?

What is the difference between cytology and histology? I would like to raise this question due to the fact that many people in non-medical professions do not see the differences between these two areas and consider cytological diagnosis to be a section included in histological analysis.

A cytogram shows the structure and condition of a cell and its organelles. Clinical cytology (and its important branch - oncocytology) is one of the sections of clinical laboratory diagnostics, aimed at searching for pathological processes, including tumor ones, that change the state of cells. To evaluate a cytological preparation, there is a special scheme that the doctor adheres to:

• Stroke background;
• Assessment of the condition of cells and cytoplasm;
• Calculation of nuclear plasma index (NPI);
• State of the nucleus (shape, size, state of the nuclear membrane and chromatin, presence and characteristics of nucleoli);
• The presence of mitoses and the height of mitotic activity.

There are two types of cytology:

1. Simple cytological examination, including taking a smear, applying it to a glass slide, drying and staining according to Romanovsky, Pappenheim or Papanicolaou (depending on the dyes and methods used by the laboratory) and viewing the smear under a microscope, first at low (x400) and then at high magnification (x1000) with immersion;
2. Liquid oncocytology, opening up new perspectives, allowing the doctor to most accurately determine the state of the cell, its nucleus and cytoplasm. Liquid oncocytology is, first of all, the use of modern high-tech equipment (Cytospin) to isolate, uniform distribution cells on glass, preserving their structure, which ensures lung doctor identification of cellular material after staining microslides in special automatic devices. Liquid oncocytology undoubtedly provides fairly high reliability and accuracy of results, but significantly increases the cost of cytological analysis.

Oncocytological diagnosis is carried out by a cytologist and, of course, in order to see all this, he uses immersion and high magnification of the microscope, otherwise the changes occurring in the nucleus are simply impossible to notice. While describing the smear and establishing its type (simple, inflammatory, reactive), the doctor simultaneously interprets the smear. Due to the fact that cytology is more descriptive than establishing accurate diagnosis, the doctor can afford to write the diagnosis under a question mark (in histology this is not accepted, the pathologist gives an unambiguous answer).

As for histology, this science studies tissues which, when preparing specimens (biopsy, autopsy), are cut into thin layers using special equipment - a microtome.

Preparation histological specimen(fixing, wiring, pouring, cutting, painting) - the process is quite labor-intensive, requiring not only a highly qualified laboratory technician, but also a long time. The histology (series of specimens) is “reviewed” by pathologists and a final diagnosis is made. Currently, traditional histology is increasingly being replaced by a new, more progressive direction - immunohistochemistry, which expands the possibilities of histopathological microscopic examination of affected tissues.

Gynecological oncocytology (cervix)

A smear is taken during a gynecological examination using a cytobrush, and then the material is placed on glass (for liquid oncocytology, a removable cytobrush is used, which, together with the material, is immersed in a bottle with a special medium). Oncocytology of the cervix, as a rule, is not limited to one smear (vaginal portion of the cervix), since there is a need to study the epithelium of the cervical (cervical) canal. This happens because the most problematic area in relation to the oncological process is the junction zone (transformation zone)– the place of transition of the multilayered squamous epithelium of the vaginal part of the cervix (ectocervix) into the single-layer prismatic (cylindrical) epithelium of the cervical canal (endocervix). Of course, it is unacceptable to “slap” both smears on one glass during diagnosis (this is only possible during a medical examination), because they can get mixed up and the smear will turn out to be inadequate.

Young in cervical smear healthy woman you can see cells of the superficial and intermediate layer (in different proportions) of non-keratinizing four-layer squamous epithelium growing from the basal cell, which is normally located deep and does not enter the smear, as well as cells of the prismatic epithelium of the cervical canal.

Differentiation and maturation epithelial layers occurs under the influence of sex hormones (phase I of the cycle - estrogens, phase II - progesterone), therefore smears in healthy women different phases menstrual cycles are different. They also differ during pregnancy, pre- and postmenopause, and after radiation and chemotherapy exposure. For example, the presence in a smear elderly woman more than 10% of superficial cells makes you wary, because their appearance, in addition to inflammation, leukoplakia, vaginal dermatosis, may indicate the development of a tumor of the genital organs, breast, and adrenal glands. That is why the referral for a smear for oncocytology always indicates:

• Woman's age;
• Cycle phase or gestational age;
• The presence of an intrauterine device;
• Gynecological operations (removal of the uterus, ovaries);
• Radiation and chemotherapy treatment (reaction of the epithelium to these types of therapeutic effects).

If necessary (if the hormonal type of smear does not correspond to age and clinical data), the doctor conducts a hormonal assessment using vaginal preparations.

Issues of cervical carcinogenesis

Human papillomavirus

Issues of cervical carcinogenesis are often associated with the penetration into the body of a chronic resistant infection such as the human papillomavirus (HPV) high risk. Human papillomavirus (HPV) can only be detected by indirect signs(koilocytes, multinucleated cells, parakeratosis) and even then, after the virus was activated, it left the nucleus of the basal cell transition zone into its cytoplasm and “moved” to more superficial epithelial layers. The conclusion “mucosal epithelium with signs of papillomavirus infection” is worthy special attention, because HPV, for the time being, “sitting quietly”, can lead to the development of a precancerous and then a malignant process.

Thus, the identification and study of this DNA virus is very important in oncocytology, since it relates to the factors of malignant transformation of stratified squamous epithelial cells into cervical precancer - dysplasia (CIN), non-invasive cancer in situ and, finally, into invasive tumor diseases.

Unfortunately, in a smear for oncocytology in women without dysplasia, but with high-risk HPV, the detection dangerous virus does not reach even 10%. However, with dysplasia this figure increases to 72%.

It should be noted that signs of HPV infection in a smear are most noticeable in mild and moderate degree, but practically do not appear in severe CIN, so other research methods are required to identify the virus.

Dysplasia

A cytological diagnosis of dysplasia (CIN I, II, III) or cancer in situ is already considered bad oncocytology (the term is not entirely correct, more correctly “bad cytogram”).

Dysplasia is a morphological concept. Its essence boils down to disruption of the normal layering in multilayered squamous epithelium and access to different levels a layer of cells such as basal and parabasal (cells of the lower layers that do not normally appear in a smear of a young healthy woman) with characteristic changes nucleus and high mitotic activity.

Depending on the depth of the lesion, there are weak (CIN I), moderate (CIN II), severe (CIN III) degrees of dysplasia. It is almost impossible to distinguish the preinvasive form of cancer (carcinoma in situ) from severe dysplasia in an oncocytology smear. Cancer that has not left the basal layer (cr in situ) can be difficult to differentiate from CIN III and histological analysis, but the pathologist always sees the invasion, if it exists and the fragment of the neck in which it occurs is included in the preparation. When identifying the degree of dysplasia, the cytologist takes the following criteria as a basis:

• Weak degree (CIN I) is assigned if 1/3 of basal type cells are detected in smears of a young healthy woman in the absence of signs of inflammation. Of course, mild dysplasia will not develop into a malignant tumor overnight, but in 10% of patients it will reach a severe stage in less than 10 years and in 1% it will transform into invasive cancer. If there are still signs of inflammation, then when deciphering the smear, the doctor notes: “Inflammatory type of smear, dyskaryosis (changes in the nucleus)”;
• Moderate the degree of dysplasia (2/3 of the field is occupied by cells of the basal layer) should be distinguished from the cytological picture in menopause (to exclude overdiagnosis of CIN II), but on the other hand, the identification of such cells with dyskaryosis in reproductive age gives every reason to make a diagnosis: CIN II or write: “The changes found correspond to moderate dysplasia.” Such dysplasia develops into invasive cancer in 5% of cases;
• Oncocytology of the cervix captures well expressed (heavy) degree of dysplasia. Doctor in in this case writes in the affirmative (CIN III) and urgently sends the woman for further examination and treatment (the risk of developing cancer in such circumstances is 12%).

cervical dysplasia

Oncocytology of the cervix shows not only the inflammatory process and dysplastic changes in the stratified squamous epithelium. With the help of cytological analysis it is possible to identify other neoplastic processes and malignant tumors in this area (squamous cell carcinoma, glandular hyperplasia with atypia of dysplasia type I, II, III, cervical adenocarcinoma varying degrees differentiation, leiomyosarcoma, etc.), and according to statistics, the coincidence of the cytological interpretation of the smear and the histology conclusions is noted in 96% of cases.

Inflammation

Although the cytologist’s task is not to examine the smear for flora, the doctor nevertheless pays attention to it, since flora often explains the cause of inflammation and reactive changes in the epithelium. The inflammatory process in the cervix can be caused by any microflora, therefore a distinction is made between nonspecific and specific inflammation.

Nonspecific inflammation occurs:

• Acute(up to 10 days) – the smear is characterized by the presence of a large number of neutrophilic leukocytes;
• Subacute and chronic when in the smear, in addition to leukocytes, lymphocytes, histiocytes, macrophages, including multinucleated ones, appear. It should be noted that a simple accumulation of leukocytes cannot be perceived as inflammation.

The cytological picture of specific inflammation is determined by the influence of specific pathogens that enter the body and begin their development in the genital organs of the new host. It can be:

Thus, inflammation can be caused by the presence of various pathogens of a bacterial and viral nature, of which there are about 40 species (only a few of them are given as an example above).

table: norms of smear results for women, V - material from the vagina, C - cervical canal (cervix), U - urethra

As for opportunistic bacterial flora and leukocytes, the whole point here is their number in each phase of the cycle. For example, if a cytologist clearly sees an inflammatory type of smear, and the cycle is coming to an end or has just begun, then the presence of a large number of leukocytes cannot in any way be considered as a sign of inflammation, because the smear was taken from a non-sterile area and such reactivity only indicates that menstruation will begin soon ( or just finished). The same picture is observed during the period of ovulation, when the mucus plug comes off (there are many leukocytes, but they are small, dark, immersed in mucus). However, with a truly atrophic smear, which is typical for older women, the presence of a large number of surface cells and even a small flora already indicates an inflammatory process.

Video: smear for oncocytology and how to take it correctly

Cytology smear from the vagina (Papanicolaou smear, Pap test, smear for atypical cells) is a laboratory microscopic examination that allows you to identify abnormalities in the cells of the cervix.

What does a cytology smear show?

A cytological smear evaluates the size, shape, number and arrangement of cells, which makes it possible to diagnose background, precancerous and cancerous diseases of the cervix.

What are the indications for taking a smear for cytology?

This test is prescribed to all women over 18 years of age once a year, as well as for:

• pregnancy planning;
• infertility;
• menstrual irregularities;
• genital herpes;
• obesity;
• human papillomavirus;
• taking hormonal contraceptives;
• a large number of sexual partners.
• before inserting an intrauterine device;

How to prepare for research?

Before visiting a gynecologist for tests, you should:

• abstain from sexual intercourse for 1-2 days;
• do not use vaginal medications (creams, suppositories, lubricants) and do not douche for 2 days;
• before submitting a smear for cytology, it is recommended not to urinate for 2-3 hours;
• It is not recommended to submit a smear for cytology if you have symptoms such as itching and vaginal discharge.

It is advisable to take a smear for cytology immediately after menstruation, on the 4-5th day of the cycle.

How is a smear taken for cytology performed?

A smear is taken during a gynecological examination with a special disposable small brush from the outer and inner surface of the cervix. The procedure for taking a smear is painless and takes 5-10 seconds.

Could there be any discomfort after a smear for cytology?

Since the doctor makes a scraping during cell collection, some may experience slight spotting from the vagina for 1-2 days.

How many days does it take to prepare a smear for cytology?

1 working day.

How is the result of a smear for cytology assessed?

A smear is considered normal or negative when all cells are normal sizes and shape, there are no atypical cells.

To describe a smear for cytology, doctors use special terms: dysplasia 1, 2, 3 degrees, atypia. For grade 1 dysplasia, the study must be repeated after 3-6 months.

What to do if pathological cells are detected in a cytology smear?

In this case, the doctor recommends additional examination. This could be a simple repeat of the smear cytology test some time after the first result. Sometimes a colposcopy with a biopsy of the cervix is ​​prescribed to clarify the diagnosis, based on the results of which a decision on the treatment method is made.

A smear for oncocytology is carried out for early diagnosis cancer. Using this technique, it is possible to identify a precancerous condition, including cervical polyps.

In pregnant women, it is important to promptly diagnose changes in the cervical epithelium various stages. Otherwise, the disease will progress. Everyone should take a smear for oncocytology future mom before registration. Repeated examination is carried out in the 2nd and 3rd trimesters of pregnancy. During the collection of material, the patient feels slight discomfort. To do this, the gynecologist uses a spatula. The material is applied to 2 glasses. The samples are sent to the laboratory. The transcript of the analysis will be ready in 5-10 days.

To take a smear for oncocytology, patients must abstain from sexual activity for 2 days, not use tampons, vaginal creams and douching. The study is carried out during the menstrual cycle. You should not take a smear if you have inflammation of the reproductive system.

To examine a sample, laboratory technicians use 2 methods:

1. According to Leishman.
2. Rar test.

The 2nd method is characterized by complex mechanism staining of biomaterial. The research method is selected by the doctor in each case individually. Oncocytology analysis is performed in the following cases:

• active sex life;
• annual examination;
• if the woman is over 30;
• during pregnancy;
• disrupted menstrual cycle;
• various pathologies of the cervix;
• manifestation of symptoms of TORCH infection.

Ready results

If there are no atypical cells in the smear, then the cervix is ​​healthy.

A positive result indicates the presence of atypical or atypical cells on the cervix.

Atypical units are observed during development infectious diseases which are sexually transmitted.

In this case, the specialist prescribes to the patient additional research. Oncocytology of the cervix indicates the stage of development of the pathology or its complete absence. Stage 2 is characterized by deviations from the norm associated with inflammation of the genital organs female body. With the development of the 3rd stage, single atypical cells are detected. To confirm the diagnosis, the woman undergoes additional examination. At stage 4, several malignant cells are detected in the sample. Stage 5 is characterized by a large number of malignant cells. If the oncocytology result significantly deviates from the norm, colposcopy is prescribed.

With the help of this study it is possible to identify various diseases, including inflammatory processes. In this case, the following changes are detected in the smear:

• increased number of white cells;
• fungi;
• abnormal appearance of epithelial cells of the cervix and cervical canal.

Using a smear for oncocytology, papillomavirus infection can be detected. HPV affects the epithelium of the reproductive system, being the main cause of the appearance of warts in the external genital area. This increases the risk of developing cervical cancer. Koilocytes are smaller cells of the cervix with a light rim. If they are identified by a laboratory technician, then the patient is infected with the papilloma virus.

Identification and development of diseases

If the specialist identified several scales of squamous epithelium in the material being examined, then the result is considered normal. Using the diagnostics in question, it is possible to identify changes in cervical cells that are characteristic of dysplasia, a sign of inflammation. In this case, the patient should undergo anti-inflammatory and antibacterial therapy. If dysplasia occurs in a moderate or severe form, then the patient must undergo an additional examination - a cervical biopsy. A laboratory technician examines a piece of tissue taken from the affected area. Taking into account the results obtained, treatment is prescribed:

• cauterization;
• deletion.

If a pregnant woman needs to undergo a cervical biopsy, the attending physician must first take into account the extent of the pathology and the duration of pregnancy. For dysplasia mild degree anti-inflammatory treatment is carried out. Then a repeat study is scheduled.

If you suspect oncological diseases Colposcopy is prescribed. This procedure involves examining the vagina and cervix using a special microscope. The colposcope allows you to see the changed areas, assessing their size, location and severity. The areas are pre-treated acetic acid or Lugol's solution.

Colposcopy is a painless procedure that can be performed in any trimester of pregnancy. 1-2 days before the study, it is recommended that the patient abstain from sexual activity, douching and vaginal products. Otherwise, you may get a false result.