Cytology in gynecology. What it is, the types of analysis as taking a smear, how many days is that shows decoding, which means

For diagnosing atypical onkokletok when studying samples of epithelial tissue pelvic examination is used, which is called cytology. Such analysis ensures early detection of inflammation, dysplasia, a precancerous condition, oncology genital tract in the early stages.

What is a Pap cytology

Cytology in gynecology - it is non-invasive microscopic examination of samples of genital tract structures allowing to identify atypical cells, inflammation, endometrial dysplasia, cervical cancer at an early stage.

During the analysis, by means of special tools is scraping the epithelium. The resulting biomaterial is evenly applied to labeled glass is dried, colored indicators examined under a microscope.

To smear taken cellular tissue:

• columnar epithelium (cervical canal);
• non-cornified multilayer flat epithelium (vagina);
• transition zone (compound vagina and the uterine cervix).

Cytology: types of stroke

There are two types of research:

• Onkotsitologicheskoe study of cervical, uterine cervix, which allows to determine inflammatory process, changes in cell structure and condition of the layers of the genital organs, on oncology 1-2-th stage.
• Smear establishing the origin and content of the vaginal microflora. Shows a state mucosa, presence of viral, bacteriological infections, fungal pathogens.

Purpose of analysis

Gynecological cytology - it is a study of cellular tissue, indicating the slightest changes in epithelial structure (appearance of atypical cells). Pap analysis reveals a deviation from the norm, threatening subsequently transform into a malignant neoplasm.

Furthermore onkokletok, Pap test evaluates the vaginal mucosa, shows the appearance of inflammatory and infectious dysfunctions bacteriological nature. Cause inflammation of the analysis does not establish, to clarify the type of infection is further carried out a smear on flora.

There are 2 kinds of results onkotsitologicheskogo study:

• positive - in the structure of epithelial tissue are abnormal cells, provoking inflammation;
• negative - indicating the purity of the genital structures, the absence of a dysfunctional cellular changes.

Indications for analysis

Pap test should be held annually for all women 18 to 65 years. The initial survey is conducted after the first sexual contact.

Unscheduled onkotsitologichesky smear is indicated for:

• preparatory process to establish the intrauterine device;
• failures in the menstrual cycle;
• long-term use of hormonal contraception;
• primary sex (defloratsii);
• planning a pregnancy;
• establishing the causes of infertility;
• HPV diagnosis in the patient, genital herpes;
• frequent change of sexual partners;
• there are more than 3 deliveries over the past 5 years;
• birth of a child girl under the age of 18 years;
• beginning predklimaksnogo syndrome;
• a history of predisposition to cancer;
• previously cured malignant tumors of the reproductive system;
• Vaginal bleeding of unknown etymology;
• obesity;
  
• injury of the vaginal mucosa, uterine cervix.

Contraindications for cytology

Restrictions on the Pap test:

• acute genital inflammation;
• menstrual bleeding;
• virginity;
• genital infection.

After birth, cytology allowed to spend 3-4 months.

The presence of inflammation genital infections not give reliable results because of the large number of leukocytes in the mucosa of the genitals.

During monthly onkotsitologichesky smear is not taken. Red blood cells interfere with the opportunity to assess the state of the epithelial tissue.

Fence smear during pregnancy

During pregnancy, routine cytological examination carried out at least 3 times. PAP-test task is to examine the vagina bioflora expectant mother, early detection of the presence of infection, the possible development of dysplasia. re-analysis is carried out in case of a positive result.

Routine Pap held:

• In setting up the expectant mother at antenatal clinics.
• On the 30 th week of pregnancy. Controlled change of epithelial tissue.
• On the 36th week of pregnancy (preparation for birth attendants). The doctor examines the genitals to prevent possible infection of the newborn as it passes through the birth canal.

In the case of women's complaints of itching, burning, pain in the vagina is assigned additional study.

Genital changes in cell structure allows to install:

• fetal death (occurrence of atrophic cells);
• Prolonged pregnancy;
• threat of premature birth;
• Fetal hypoxia;
• Cancer development process;
• inflammation, infection of sexual penetration.

Possible complications after stroke fence

Cytological procedures in gynecology painless. With this study, the expert takes care epithelial tissue, in a circle, with one movement.

Damage to the epithelium can cause red blood cells in the biomaterial, makes it impossible for a reliable assessment of cellular structures. Unpleasant sensations during smear may occur when installing the speculum.

After the procedure, the woman is allowed to lead a normal life, play sports, engage in any physical activity. Sex is not forbidden. painful spasms in the abdomen may occur in rare cases, spotting of bleeding.

Cause said dysfunction are:

• Rough removal of cells inexperienced physician in violation of the analysis technique.
• Injury to the epithelium. In this case, you may receive incorrect results PAP test.
• The presence of inflammation of the genitals.

Within 2 days spasms and blood separation self-destruct. When you see these symptoms should refrain from sexual intercourse. Saving the unpleasant consequences of analysis for 3-4 days treatment requires medical help. You should not self-medicate.

Terms of training women to analysis

The preparatory phase should start in 2-3-th day before the procedure.

During this time, required to refrain from:

• Any sexual contact;
• douching;
  
• Contraceptive vaginal application, suppositories, tablets;
• hygienic toilet soap genitalia using means;
• receiving baths in swimming pool waters;
• the use of antibiotics.

Sampling analysis should be carried out 6-12 days of the menstrual cycle. During withdrawal bleeding biomaterial is not carried out. Blood distorts the result data.

In the case of gynecological examination, colposcopy Pap test is delayed for 72 hours. Analysis is not appointed during the acute inflammation of the sexual sphere. Smear on onkotsitologiyu carried out after the disappearance of symptoms. 2 hours before analysis should refrain from using the toilet.

Tools for analysis

For the collection of material for cytological study used:

• spatula Eire - a tool to remove the cells from the uterine cervix, the junction with the reproductive organs.
• Spirette - ultrasonic aspirator studying biomaterial endometrium.
• Endobrash - a one-time tool used for analysis without the need for cervical dilatation.
• speculum - inserted into the vagina for disclosure. It helps in the study of the state of the mucous and the uterine cervix.
• Tweezers.
• spoon Folkmena - a device for gripping epithelial tissue of the cervical canal.
  
• Slide - a transparent substrate to which the biomaterial is placed withdrawn for drying.
• saline - is used to cleanse the genital secretions before taking analysis.

How to take a smear of cervical cytology

The best period for biomaterial sampling for the Pap test is the time from the 5th day after the start of the menstrual cycle (after the disappearance of spotting) on ​​the 17th day. At the time of ovulation (12-14 days) produces large amounts of mucus that makes it difficult to study tissues.

Procedure for onkotsitologicheskogo smear:

1. The patient undresses, is located on the chair for gynecological examination. Under the buttocks of the woman is enclosed disposable diaper.
2. Gynecologist establishes the vagina expander (speculum), estimates the distance of the neck.
3. With swab wetted in saline, secretions are cleaned portion 3 (cervix, vagina, the fallopian place genitalia and cervix compound). Mucus plug is removed with a brush.
4. Disposable sterile instruments (Eire spatula, spoon Folkmena, endobrash, tweezers) are placed in the woman's genitals. Accurately, quickly turning on 360⁰ produced separating the epithelial cells of the tissue. If the doctor finds a questionable site, then taken further analysis.
5. evenly applied to the samples taken are marked with a glass slide. Doctor signs the name, age of the patient.
6. Biological material is dried, transferred to the laboratory for testing.
7. Specialist studying samples assesses quality, purity tissue analysis technique. In case of questionable results, it is recommended to re-smear. Annually repeated until 20% of PAP-test for non-physician cell sampling procedure. Biomaterial prepared dye indicators considered under the microscope.

smear sampling procedure takes no more than 15-20 minutes. Non-invasive, painless. Discomfort may occur when establishing the speculum. After removal of the biomaterial women dress, returned to normal life.

Decoding results

Cytology in gynecology - is such a study, which allow data to detect the cancer at an early stage.

There are 2 Pap test:

• negative - Talking about the health of the woman;
• positive - indicating the appearance of abnormal cells in the epithelium.

To decrypt the data analysis methodology employed smear effusing 5 stages of cell structures change:

1. State standards. He speaks about the patient's health. In these samples no change.
2. Detected a small number of abnormal cells. Appearing in inflammatory processes in the genital area caused by bacteria, viral infections. It requires the use of antibiotic therapy.
3. It indicates a single accumulation of atypical cells with little damage to the structure of the nucleus, cytoplasm. Diagnose erosion cervical polyps.
4. The samples have a large number of transformed cells with increased membrane broken chromosomes cytoplasm. Evidence of dysplasia, a precancerous condition possible genitals. A woman with this analysis is put on medical control, biopsy, colposcopy.
5. Carcinoma. Oncological disease. The structure of epithelial tissue completely changed. A large number of atypical cells. Immediately appointed additional studies, anticancer therapy.

Explanation on a method Bethesda assay:

designation	Determination of value
Norm	Absence of pathologies, changing the cell structure. May develop bacterial infections, vaginosis, cervicitis
HPV	At present koylotsity smear - HPV cells. They vary in type. 16.22 are considered the most dangerous, increase the risk of cancer pathology
CIN I	Dysplasia of the 1st degree
CIN II	Dysplasia of the 2nd severity
CIN III	Dysplasia of the third degree. a precancerous condition
Carcinom (pax)	Carcinoma. Oncology.

Terminology values ​​used in cytology:

• GSO - normal levels of biological material, lack of pathology.
• cervicitis - cytogramme inflammation.
• Large cluster of normal columnar epithelium - polyps, hyperplasia of the epithelium of the cervical canal.
• surface layer of epithelium cells - fibroids, a benign tumor.
• Battered epithelial cells, pathogenic microorganisms. Indicate the presence of mycoplasma, ureaplasma in women.
• Mixed (kokkobaktsillyarnaya) flora - genital infections: trichomoniasis, gonorrhea, mycoplasma, chlamydia, syphilis.
• Taurus Provagelya - Chlamydia trachomatis.
• multi-layer cell - genital herpes.
• leukocytic infiltration - increased number of leukocytes in the smear. Suggests vaginosis, Endocervicitis, endotservite.
• Koylotsity - the presence of Human Papilloma Virus cells (HPV).
• Proliferation - accelerated cell division. It detects the presence of inflammation in the uterine region. Adjusted antibiotics.
• leukoplakia - pathology no malignancy.
• Metaplasia - substitution process of the cell is detected in the case of benign tumors.
• Dysplasia - a precancerous condition. In the absence of medication adjustments in the future (about 10 years) is able to transform into carcinoma.
  
• ASC-US - squamous cells of unknown origin. Often occur in women older than 45 years.
• AGC - cylindrical cell changes. These data require further study destination.
• L-SIL - a small number of abnormal cells in the biomaterial, often caused by inflammation of the genital area.
• ASC-H - a precancerous condition, the 1st stage of the cancer process.
• HSIL - oncocitology. In the epithelial tissue cells lasting changes detected broken structure chromosome membrane. Revealed the destruction of the squamous epithelium.
• AIS - malignancy caused cylindrical structure cells.

Abnormal cells in cytological smears:

• Metaplazirovanny epithelium - normally found in small amounts. Increased number of cells is detected by substituting the monolayer layered cell structures. It is characteristic for inflammation caused by infections (chlamydiosis, toxoplasmosis, herpes), hormonal disorders, frequent abortions, occurs when frequent change of sexual partners.
• glandular epithelium - not normally found. Not subject to adjustment by increasing the number of cells during pregnancy, hormonal contraceptives. In the absence of such reasons is observed in cervicitis, coleitis, hormonal disorders. It appears after vaginal injuries after childbirth, abortion, curettage, gynecological manipulations.
• squamous epithelium - detected by 5-15 pc in normal analysis. The absence of cell informs vaginal atrophy, uterine cervix, the propensity to cancer process in the future. More than 15 pieces. It means the development of inflammation, primary infertility, benign tumor.
• erythrocytes - are detected in the capture assay 1-4 days of the menstrual cycle, in the event of seizure art samples (genital trauma with subsequent bleeding) acute inflammatory process. The appearance of the analysis makes it possible to detect onkokletki.
  
• atypical cells - transformed structure with the structure of a violation under the influence of the inflammatory process. Indicate erosion, abnormal genitalia. Is not the basis of diagnosing cancer without further study.
• Rod-shaped (coccal flora) - in the normal state is absent. It appears when the inflammatory process caused by pathogenic microorganisms. It provides a basis for analysis on sexual infections.
• mushrooms - absent in healthy patients. Evidence of bacterial vaginal candidiasis.

Atrophic type of stroke - occurs when estrogen deficiency. Predklimaksnogo characteristic of the syndrome, menopause. It requires hormone replacement therapy, progesterone.

Inflammatory Pap test - occurs when a biomaterial fence during an acute inflammatory process. Not informative.

It needs to be repeated after the normalization condition and antibiotic therapy. In the absence of any biomaterial placed value changes - no pathological changes. Cytological examination does not give an accurate result.

Upon detection of disease (particularly cancer) requires urgent additional research:

• repeat Pap smear;
• colposcopy;
• General blood analysis;
• studies for tumor markers;
• blood chemistry;
• biopsy;
  
• Test to determine the types of human papillomavirus.

How many days do smear cytology

Cytology gynecological (such studies is the cellular structure of epithelial tissue) is carried out for a period of from 1 to 5 days. To pass the analysis must apply to the antenatal clinic in the community, a gynecologist at any private clinic. The cost of the study from 1500 to 3500 rubles. depending on the region, the clinic, the speed of implementation, interpretation of the results.

Unpainful cytological analysis in gynecological practice - it is non-invasive study of skin cells, making it possible to detect the presence of abnormal cells.

This study is being conducted everywhere. It helps to diagnose changes in cellular structure, to prevent and cure cancer at an early stage with minimal risk to the woman's life.

Registration of the article: Lozinski Oleg

Video of cytology in gynecology

What is the analysis of cytology and how it is done: