A smear for cytology: what shows how the analysis is taken, decoding
The content of the article:
- What does a smear show for cytology
- Who is the study of a cervical smear indicated?
- How to prepare for the study
- How to take a smear for cytology
- How many days does a smear take for cytology
- Decoding the results
What does a smear show for cytology, and for what purpose is it prescribed? This method of laboratory diagnostics is necessary for the early detection of cervical cancer, one of the most common oncological diseases of the female reproductive system. This is an inexpensive and informative study that aims to identify atypical cells characteristic of the presence of a malignant process.
A smear for cytology is recommended for all women from the age of 18
A smear for cytology - what is it? This is a cytological analysis of a scraping from the cervix, the so-called Papanicolaou test, or, as the doctor usually writes in the direction of research, the PAP test.
In 1943, the scientific work of the Greek physician G. Papanikolaou "Diagnosis of uterine cancer using smears" was published in a specialized medical publication. It aroused great interest among the medical community, and the proposed diagnostic method became widely used in clinics. After the name of its creator, a smear for cytology from the cervix began to be called a Pap smear, or abbreviated as a PAP test. By watching the video on YouTube, you can learn more about Georgios Papanikolaou and his discovery, which made it possible to reduce mortality from cervical cancer tenfold.
What does a smear show for cytology
The PAP test is a highly informative, inexpensive and fast method for laboratory diagnosis of cervical diseases. Its main goal is:
- identification of atypical cells indicating a malignant process;
- diagnosis of cervical dysplasia, which is a precancerous disease.
Mass examination of cervical smears (cervical screening) is the main method of secondary prevention of cervical cancer, i.e., a method aimed at detecting the disease as early as possible (primary prevention, i.e. a method of preventing the development of cervical cancer, is vaccination of girls against HPV, human papillomavirus).
Who is the study of a cervical smear indicated?
Every adult woman who is not vaccinated with HPV before sexual activity is at risk of developing cervical cancer. Therefore, a cytological examination of a smear from the cervical canal must be performed for every woman, starting from the age of 18. The test is recommended to be carried out annually until the age of 30, regardless of whether the woman is currently sexually active or not (with the exception of virgins). After 30 years and if there is only one sexual partner, it is done once every three years.
In some cases, a smear for cytology is performed more often, for example, if women have dysplasia of the cervical mucosa or infection with oncogenic HPV strains is detected in the body, that is, with an increased risk of cervical cancer.
An unscheduled cytological examination of a smear from the cervix is performed in the following cases:
- planning pregnancy;
- infertility;
- suspicion of infection with an oncogenic HPV strain;
- endocrine diseases (diabetes mellitus, obesity, metabolic syndrome);
- the appointment of hormonal contraception;
- the upcoming installation of the IUD.
How to prepare for the study
In order for the results of a cytological analysis to be reliable, a number of conditions must be met before performing it:
- the smear is taken after the end of menstruation, in the first half of the menstrual cycle, that is, until the next ovulation;
- 48 hours before visiting a gynecologist, you must refuse to have sexual intercourse;
- two days before the procedure, you should stop using vaginal suppositories and creams, tampons;
- in three days, vaginal douching is stopped.
A smear for cytology should be taken before colposcopy or two-handed gynecological examination, or not earlier than 48 hours after their completion.
If the patient has acute or chronic inflammatory diseases of the reproductive system in the acute stage, then a smear should be taken only after completion of their treatment.
How to take a smear for cytology
A Pap smear is taken from a woman during a pelvic exam. The woman lies down in a chair. The gynecologist carefully inserts the Cuzco speculum into the vagina, exposes the cervix and wipes it with a tampon moistened with saline. After that, the mucous plug is removed from the cervical canal using a wooden scraper or a special brush.
Directly for taking a smear from the cervical canal, disposable sterile instruments (endobranch, screen, Volkmann spoon, Air spatula) are used. One of them is carefully inserted into the lumen of the cervical canal and slowly rotated around the axis, collecting pieces of mucus on its surface. Scraping is taken in the transition zone of the cervix, that is, in the place where the stratified squamous epithelium becomes cylindrical.
After removing the instrument, this mucus is transferred to a clean glass slide. The Cuzco mirror is removed and the patient can get up from the chair.
The procedure for taking a smear for cytology is painless. However, sometimes patients with a labile nervous system complain of mild discomfort of pressure in the lower abdomen.
The microscope slide is immersed in 96 ° ethanol for several minutes in order to fix it, and dried in air. After that, they are placed in an envelope and sent to the laboratory for cytological examination.
A smear is taken from the cervical canal, at the junction of the squamous epithelium into the stratified
How many days does a smear take for cytology
The duration of laboratory examination of a smear from the cervical canal in different medical institutions is from 3 to 10 days. This analysis is most quickly done in laboratories equipped with special analyzing systems.
Decoding the results
Depending on the result obtained, five classes of smears are distinguished:
- The sizes and shapes of the cells correspond to the physiological norm, there are no signs of atypia.
- There are cell changes associated with cervicitis or colpitis.
- Single cells with changes in the nucleus and / or cytoplasm are identified.
- Isolated malignant cells.
- Malignant cells in significant numbers.
In addition, the Bethesda classification system is widely used in decoding smears for cytology:
- Low rate of change. These include coylocytosis (cellular changes caused by HPV infection) and CIN I (initial stage of cervical dysplasia). Corresponds to I and II class of smears.
- High rate of change. Includes CIN II, III (moderate to severe cervical dysplasia), carcinoma in situ (early stage of malignant tumor). These changes correspond to class III-V smears.
In the forms of some laboratories, variants of the cytological picture of a smear may have other designations:
- NILM - class I smear, norm;
- ASCUS - atypical cells with changes of undetermined significance are present, which can be caused by chlamydia, HPV, dysplasia or mucosal atrophy;
- ASC-H - squamous cell atypical epithelium is found in the smear, which is characteristic of moderate or severe dysplasia, as well as early stages of malignant tumors;
- LSIL - altered cells in a small amount (typical for HPV infection or initial degree of dysplasia);
- HSIL - cellular changes are pronounced, which corresponds to moderate and severe dysplasia, stage 0 cancer;
- AGC - altered cells of the glandular epithelium (dysplasia, cancer of the uterine body) are detected;
- AIS - early stage carcinoma;
- High-grade SIL is a cancer originating from squamous epithelial cells.
For any result of a smear on cytology, a woman needs a consultation with a gynecologist. If the test reveals deviations from the norm, the doctor will send for further examination (ultrasound of the pelvic organs, extended colposcopy, cervical biopsy, separate diagnostic curettage followed by histological examination of scrapings).
Ornament app
Every woman should undergo not only a PAP test every year, but also other medical examinations. It is convenient to monitor the level of basic health indicators using the free Ornament smartphone app. In one profile, you can accumulate the results of any laboratory tests of all family members. To enter data into the Ornament database, you just need to photograph the form with the results from the laboratory. The application will compare the indicators with normal values and assess the state of the main body systems. In the section "Community" you can get advice from users with medical education.
A very handy application for storing and organizing medical analyzes - Ornament. Available for free in the AppStore and Google PlayMarket.
YouTube video related to the article:
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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