Squamous epithelium in a smear is a medical concept used by doctors who study the health of the reproductive system of women and men. Identification of epithelial cells in biomaterial is carried out in the laboratory, and their number can tell a specialist both about the normal state of the genital area and about various pathological processes occurring inside and outside the human body. To obtain such information, a person must undergo a cytology smear, which is often called a microflora smear.

What is squamous epithelium?

For a gynecologist or urologist, the flat epithelium in a smear for microflora is an important source of information, even though the doctor himself cannot examine these microparticles when taking a smear. Cells and layers of epithelium are detected during the study of biomaterial taken from the surface of the cervical canal and from the walls of the vagina in women or from the urethra in men under a microscope.

Almost our entire body is covered with some kind of protective shell, which we call skin. But the skin in the mouth, around the eyeball, in the vagina, in the urethral canal, etc. is somewhat different because it is not made of such durable material. Such delicate skin, covered with mucous secretions, is usually called the mucous membrane, and its surface layer, which covers the epidermis, is called epithelium.

Despite the fact that the mucous membrane is abundantly supplied with blood vessels, which explains its bright pink or red color, there are no such vessels in the epithelium. Epithelial cells are nourished through the basement membrane.

Despite the fact that the thickness of the epithelium does not exceed 150-200 microns, this coating of internal organs is considered multilayered, i.e. the cells in it are arranged in several layers. Flat epithelium is precisely the closest surface layer of the mucous membrane, consisting of flat-shaped epithelial cells.

There are 3 types of eptheliocytes: superficial, intermediate and basal, located at different levels. The lower layer, closer to the epidermis, is called the basal layer, and a layer of cylindrical (basal) cells that perform a protective function is attached to it.

But our body is constantly in motion and undergoing renewal, which also applies to epithelial cells. In the process of division (proliferation), basal cells form a layer of cells (intermediate cells) that have a complex shape with growths and spines and are located one above the other. Over time, these cells become flat and move into the surface layer, which is renewed regularly once every 5-7 days. Old cells at the very surface of the epithelium are peeled off and, together with mucus and other physiological secretions, come out.

It is this dead squamous epithelium, separated from the main mass, that doctors subsequently find in a smear. It would seem that there is nothing surprising or pathological in this, because this is a natural process of cleansing and renewal of the mucous membrane. In fact, everything depends on the number of detected epithelial cells, and both an increase and a decrease in their number compared to the norm is considered dangerous.

Flat-shaped epithelial cells are found in smears in both men and women, regardless of whether everything is fine with their genitourinary system. Since epithelial renewal is considered a physiologically driven process, it is not surprising that some squamous epithelium will be detected even in a healthy body.

Tests: how to prepare correctly

Sometimes squamous epithelium in a smear may indicate not so much a disease or some non-pathological changes in the body, but rather improper preparation for the test or incorrect taking of a smear. A gynecologist or urologist may prescribe a microflora test if the patient consults him about pain in the pelvic area, redness and swelling of the external genitalia, unusual discharge, as well as symptoms such as burning, itching, pain during urination or sexual intercourse.

Such studies can be prescribed as part of a routine medical examination or when planning pregnancy. In parallel, a urine test is usually prescribed, which helps to identify hidden diseases of the entire urinary system. But they can also manifest themselves in the form of the appearance of epithelial cells and leukocytes in the urine, while a smear allows one to judge only about inflammation at the site of its collection (urethra, vagina or cervical canal).

But no matter what analysis is prescribed, before carrying it out it is necessary to carry out hygienic procedures, i.e. thoroughly rinse the external genitalia with water without using soap or other hygiene products. If they plan to take a smear from the vagina, women think that they need to thoroughly rinse everything inside using douches. In fact, this cannot be done, since the results of the analysis will be distorted (it will not show the real content of leukocytes and epithelial cells separated from the walls).

In order for the smear results to be reliable, it is recommended to abstain from sexual intercourse and the use of contraception two days before the procedure. A visit to the toilet for minor needs should occur no later than 1.5-2 hours before the procedure.

If the cause of inflammation of the cervical tissue is radiant fungi (actinomycetes), a yellowish granular coating is found at the site of the lesion, and Candida fungi leave behind a white mass resembling cottage cheese (grainy and with a sour smell), which is very easily removed from the reddened surface.

A similar plaque is observed in leukoplakia (hyperkeratosis), a disease in which keratinization of the mucous membrane occurs (normally, keratinization of the mucous membrane is not typical). But in this case, unlike a fungal infection, a whitish or grayish coating (it can form on both the cervix and the vaginal mucosa) is difficult to remove, and the smear reveals scales of squamous epithelium, which are the cytoplasm of a cell without a nucleus.

By the way, sometimes doctors find not individual cells in a smear, but layers of squamous epithelium. If these are single formations, there is no need to worry too much, because the cells of the epithelium of the uterus and vagina are arranged in layers, so it is not surprising if they move away from the total mass in a whole area during cell renewal. But if there are a lot of such layers, this may be evidence of dysplastic processes in the uterus (dysplasia, erosion, endometriosis, cervical leukoplakia, precancerous conditions and cervical cancer), so further research and consultation with a gynecologist, and possibly an oncologist, are required.

Acute cervicitis is characterized by the presence of a large number of leukocytes in the smear (leukocytosis), lymphocytes and histiocytes appear, and cylindrical and squamous epithelium are detected. In this case, the cells of the columnar epithelium (basal layer) have an enlarged nucleus, and the flat epithelium of the surface layer in the smear has dystrophic changes (for example, scales appear that do not contain nuclei).

If the disease proceeds in a sluggish form for a long time, large numbers of columnar epithelial cells will be detected in smears, having different sizes and signs of destruction of cellular structures.

• urethritis (inflammatory process in the tissues of the urethra - urethra, which can be diagnosed in patients of both sexes).

Flat epithelium in a smear in men

For men who consult a urologist usually about various discharges from the penis, as well as such unpleasant symptoms as itching, burning and inflammation of the tissues in the urethra, a smear for microflora is taken from the urethra. In addition to bacteria, viruses, fungi and other microorganisms, exfoliated cells of flat and columnar epithelium can also be found in the mucous, whitish or purulent secretion. The urethral mucosa has a slightly different structure, so a small number of basal cells is not a pathology.

If the number of epithelial cells in the smear is higher than normal, we are talking about tissue destruction. So a large amount of flat epithelium, as in the case of women, most often indicates an inflammatory process in the genitourinary system. In this case, it is necessary to take into account not only the urinary organs (kidneys, bladder, urethra).

The inflammatory process can also be localized in the seminal sacs (inflammation of the testicle or orchitis) or the prostate gland (inflammation of the prostate or prostatitis), which are classified as genitals. And since the organs of the urinary and reproductive systems have a common outlet (urethra or urethra), there may be more reasons for discharge from the penis in men than in women, whose outlets, although located nearby, are still separated, which makes diagnosis easier. taking a smear correctly.

If we are talking about an inflammatory process, the smears will also necessarily show an increase in the level of leukocytes (more than 5 units per field of view), which are released by the immune system to fight the infection. Bacteriological studies also reveal the causative agents of the disease, which once again suggests that the appearance of squamous epithelium in the smear is not accidental.

If neither infection nor leukocytes are found in the smears, then we are talking about hyperkeratic processes (leukoplakia, etc.), which can be localized in various areas of the mucous membrane throughout the body. But you need to understand that the amount of squamous epithelium may increase slightly compared to the norm as the human body ages. Although in men this process is not so pronounced, doctors still note some changes in smear tests that are not related to genitourinary diseases.

In both women and men, the increase in the number of epithelial cells in the smear may be temporarily increased due to the use of topical agents. In this case, the situation can be considered as an unusual manifestation of an allergic reaction to the medicine. By analogy, the skin may experience itching, redness and flaking, which is also due to the rejection of surface epithelial cells.

As for the reduced number of epithelial cells in the smear, for young women this is considered an alarming symptom. With the onset of menopause, a decrease in the production of the female hormone estrogen leads to a decrease in such cells in tests, which is considered a physiologically determined age-related process. Disruption of the hormonal balance in the direction of decreased estrogen production in young women before menopause is fraught with big troubles in the form of disruption of the internal environment of the vagina and activation of pathogenic microflora.

With estrogen deficiency, gradual atrophy of vaginal cells occurs, which manifests itself in the absence of natural ovulation discharge, vaginal dryness during sexual intercourse, small vaginal spotting bleeding, burning and itching in the vagina, and frequent urge to urinate. All these are quite dangerous symptoms that can have dire consequences and cause infertility in women of childbearing age. Therefore, it is undesirable to ignore such symptoms.

Consequences and complications

In a smear for microflora, you can detect different types of epithelium: flat superficial, transitional, cylindrical, which lines the cervical canal and is periodically replaced by squamous epithelial cells. There is nothing pathological in the fact that these cells are present in biological material. This is the result of physiological processes occurring in the body. Women may have fewer such cells, women may have more, but this is also due only to the structure of their genital organs. And if the number of cells of a particular type when studying a biomaterial under a microscope does not exceed 15 units in the field of view, there is nothing particularly to worry about.

But if the indicators are too high or below the norm, this is already a reason to specifically take care of your health. Especially when it comes to women of reproductive age.

An increased amount of squamous epithelium in a smear most often indicates inflammatory processes in the urethra or vagina - organs whose surface is covered with a delicate mucous membrane. And as we know, not a single inflammatory process, especially one that lasts for a long time, goes away without a trace. Timely treatment of an acute inflammatory process, which may be indicated by a large number of exfoliated squamous epithelial cells, helps prevent possible complications.

For example, the transition to a chronic form of vaginitis threatens in the future inflammatory processes of the external genital organs, cervical erosion, inflammation of the endometrium, which in turn can eventually lead to dysplastic processes (dysplasia of uterine tissue, endometriosis, cervical cancer). In childhood, vaginitis is fraught with fusion of the labia minora and labia majora in girls.

The inflammatory process can lead to thickening of the mucosal tissue. Metabolic processes are disrupted, cellular respiration is disrupted, and mucosal tissue atrophies. Cracks and erosions may appear on the mucous membrane, which not only become an obstacle to pleasure during sexual intercourse, but also become a breeding ground for the spread of infection. If vaginitis itself is not always caused by an infection, then the appearance of various lesions on the mucous membrane will provoke its attachment.

An infection, especially of a bacterial nature, has the ability to cover increasingly larger areas, i.e. it will move upward, affecting the organs of the urinary system.

Chronic cervicitis can have identical consequences. The infection will gradually spread to other organs, causing inflammation of the appendages, bladder, and peritoneum. Its result may be the appearance of adhesions on internal organs and the development of cancer (cervical cancer does not develop as often against the background of inflammation, but such a danger still exists). In addition, the mere appearance of a large number of cylindrical and flat epithelial cells in a smear may indicate the initial stage of cancer without symptoms of cervicitis.

Urethritis in women, in the vast majority of cases caused by an infectious factor, although damage to the urethra can also be caused by urolithiasis, can cause disruption of the vaginal microflora, inflammation of the bladder and even the kidneys if the infection spreads to them.

In men, untimely or poor-quality treatment of urethritis (and even more so any therapeutic measures) causes many unpleasant consequences that will also affect sexual life:

• development of prostatitis, and as a consequence of prostate adenoma,
• the appearance of vesiculitis, orchitis and colliculitis (inflammatory processes in the seminal vesicles, testicles or seminal tubercle),
• development of balanoposthitis (inflammation of the penis in the foreskin area), etc.

Long-term inflammation in the urethra can lead to the appearance of strictures, i.e. to a narrowing of the urethra, which creates problems with urine removal from the body and often requires surgical intervention.

Patients with inflammatory diseases of the genitourinary system begin to experience problems of a sexual and psychological nature. Pain during sexual intercourse causes refusal of sexual intercourse and constant dissatisfaction of sexual partners. Quarrels and scandals begin in the family, which can also be considered a distant consequence of a careless attitude towards the appearance of a large number of epithelial cells in the smear.

Although no less sexual problems can be observed in women with an insufficient amount of epithelium in smears, in whom the lack of lubrication in the vagina leads to pain and irritation of the mucous membranes during sexual intercourse.

But pathologies in which the composition of the smear changes have much more unpleasant consequences, considering that they sometimes become an obstacle to conceiving a child. And infertility of one of the spouses often leads to family breakdown.

As we can see, the detection of squamous epithelial cells in quantities different from the norm in a smear can be considered not only an indicator of pathological processes in the body, but also an opportunity to promptly begin effective treatment and prevent the development of dangerous complications.

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But the prognosis of treatment is influenced not only by the prescribed treatment. The timing of seeking help also plays a big role. The sooner the disease is detected, the greater the chance of saying goodbye to it without consequences and complications. This applies to both inflammatory pathologies and oncological diseases, where we are no longer talking about health, but about the patient’s life.

It is clear that compliance with the doctor’s requirements will definitely affect the prognosis of treatment. If the patient does not want to undergo the full course of treatment, one usually cannot count on a good, lasting result. There is a high risk that the disease will return after a while.

Let us not once again delve into the details of the consequences that can await a person if he does not take any measures to treat the disease. It’s better to talk about how to make treatment more effective.

When treating infectious and inflammatory diseases of the genitourinary system, it is very important:

• Maintain genital hygiene. You will have to wash even more often than usual, especially during menstruation.
• You will also have to change your underwear and intimate hygiene products (tampons, pads) more often.
• All treatment procedures should be carried out after hands are thoroughly washed with soap. You should also wash your hands after performing medical procedures.
• The genitals, where the infection is hidden, require care using a separate towel. It would be better if they were disposable napkins. Otherwise, the towel will have to be washed and ironed daily with a hot iron.
• Particular attention will have to be paid to underwear. It should be made from natural fabrics, “breathable”, because the “greenhouse” effect created by synthetics only promotes the proliferation of pathogenic microflora.
• During treatment of the disease, sexual contact should be avoided. This will help prevent secondary infection and the spread of infection to other people, in particular to a sexual partner. Failure to comply with this requirement is one of the reasons for the prevalence of sexually transmitted diseases. Some patients believe that once they have started treatment, they are no longer contagious. Unprotected sex is especially dangerous.
• It is important to understand that if two people regularly have sexual intercourse, and one of them is diagnosed with an infectious disease, both partners should be treated. Even if we are not talking about sexually transmitted diseases, for example, candidiasis or vaginitis caused by opportunistic microflora, some preventive measures in the form of treating the penis with antiseptics that are effective against bacteria and fungi will not hurt. Especially when you consider that not everyone can boast of strong immunity.
• Treatment procedures prescribed by a doctor must be performed regularly and in full. Treatment should not be stopped just because the symptoms of the disease disappear. It is necessary to complete a full therapeutic course and then, if necessary, resort to preventive measures.

But any disease is easier to prevent than to cure. It is this truth that you need to be guided in your life so that there are fewer unpleasant moments in it.

To avoid infectious and inflammatory diseases of a urogynecological nature, not much is needed. It is worth paying attention to your sex life. Even if your sexual partner is permanent, you need to carefully monitor your health. After sexual intercourse, hygiene procedures will help prevent possible infection.

If we are talking about casual sex, it is imperative to use high-quality personal protective equipment (condom). And again, do not forget about genital hygiene, trying to take a shower as soon as possible.

Wearing underwear made from natural fabrics will help prevent the proliferation of opportunistic microflora, which loves places where it is warm and humid. Irritation of delicate tissues can be caused by increased humidity, as well as allergens contained in scented pads, synthetic underwear, and some intimate hygiene products, which are best avoided.

As for the prevention of diseases in which the squamous epithelium in the smear differs in quantity from the established norm, here the observance of intimate hygiene, proper nutrition, which provides the body with useful substances necessary for strong immunity, and caution in sexual contacts come to the fore. An important role is also played by maintaining the general health of the body and timely treatment of infectious diseases, regardless of their location. You must always remember the ability of infection to spread throughout the body through the blood and lymph in order to prevent such a danger in time.

It is important to know!

The coccal flora in a smear, the representatives of which have a spherical shape, can be represented in all the richness of its species. Normally, cocci, together with other opportunistic and neutral microorganisms, are present in the vagina in a total volume of no more than 5%.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Renata asks:

What does the presence of atypical cells in an oncocytology smear indicate?

In addition to inflammation, the cause of the appearance of atypical cells is tumor transformation of the cellular elements of the cervical epithelium. However, the presence of atypical cells does not mean that a woman is developing a malignant tumor. Normally, up to a million tumor cells are formed in the human body every day, which are effectively destroyed by one’s own immune system. Such tumor cells naturally form in the tissues of the cervix. But with normal functioning of the immune system, atypical cells are simply destroyed and do not cause any tumor growths. Therefore, often the detection of atypical cells in a smear indicates only physiological processes occurring in a woman’s body.

If the cytology smear results indicate only the presence of atypical cells and the degree of atypia is not additionally described, then most likely we are talking about inflammatory changes in the cervix. If the degree of atypia is also indicated, this means that the cells of the cervix have undergone some transformation, which at this stage is not dangerous, but theoretically, under certain conditions, they can become a source of tumor growth.

Therefore, if there are atypical cells according to the results of a cytology smear, it is recommended to undergo a colposcopy with a biopsy of suspicious areas of the cervix.

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Flat epithelium in a smear for flora and cytology determined in all women. Those who are of reproductive age and are not breastfeeding have more of it than those who are lactating, in the absence or depletion of ovaries, menopause (menopause) - in general, than in those who do not have a menstrual cycle.

For reference: estrogens continue to be produced in women during menopause and with the ovaries removed, since they are also produced by the adrenal glands.

The epithelium has a protective function. Thanks to it, the vaginal microflora remains rod-like, the environment is acidic, unacceptable for the proliferation of pathogenic microorganisms. The epithelial layer may decrease somewhat when taking hormonal contraceptives and glucocorticosteroids.

What types of smears reveal the presence of squamous epithelium? You can see these words in the results of a smear on the flora (the so-called general smear) and a cytogram. In this case, only the amount of epithelium will be indicated in the first one. But the conclusion of a cytological examination (Pap test) contains more information; the description will contain qualitative characteristics.

Types of epithelial cells and estrogen dependence

Squamous or stratified epithelium are the cells that line the vaginal part of the cervix. In the cervical canal, another type of epithelium is cylindrical. The flat layer consists of four types of cells - superficial, intermediate and basal-parabasal layer.

Which cells the doctor will take for analysis depends on the concentration of the main female hormone - estrogen. Flat epithelium in layers, fragments, clusters in a smear - these are all variants of the norm, if without anaplasia.

Superficial, largest cells, but with a small nucleus, are characteristic of days 9-14 of the menstrual cycle. If the analysis says that there is a large amount of epithelium, and you took it right in the middle of the cycle, then this is the reason.

Intermediate cells are found in any phase of the cycle. Their difference is their slightly smaller size, irregular shape, and larger core size.

While estrogen is at its lowest point, during menstruation, parabasal cells appear in the smear. In general, during menstruation a woman “loses” a third of her epithelium. Also, this type of squamous epithelial cells is characteristic of the period of amenorrhea (hormonal disorders)

Basal cells with a very large nucleus are characteristic of the atrophic type of smear (ATM). Diagnosed in menopausal women with at least 5 years of inactive ovaries. Also, a similar situation is observed in women with prolonged postpartum amenorrhea, if active breastfeeding continues for more than a year.

Medical terms that scare you

Dystrophy or dystrophic epithelium- happens with true erosion of the cervix or pseudo-erosion, which is also called ectopia. In a word, when there is a wound on the cervix. When it heals, cell degeneration will no longer be detected.

The cytogram often contains a medical term "metaplastic" Many people think that this indicates a malignant process. But no - metaplastic epithelium is a good smear result. This indicates that the cells were taken exactly from the desired zone - the junction of two types of epithelium - from the endocervix (cylindrical) and exocervix (flat). This is where atypia, precancerous or cancerous changes are most often found.

Acetowhite epithelium (ABE) is not an indicator that can be displayed as a result of strokes. visible during extended colposcopy after exposure of the cervix to acetic acid. If there are pathological areas on it, the epithelium will begin to turn pale. Next, the doctor draws conclusions based on how quickly the whitening occurred, how bright it was, how long it lasted, whether it had boundaries, whether there was a sign of a ridge, etc. If the reaction was not pronounced, most likely women have chronic cervicitis (inflammation ), HPV or (mild dysplasia). In case of severe ABE, the diagnosis is severe dysplasia.

In appearance, the cervix, even with severe dysplasia, can be quite healthy. And only the vinegar test shows what is not visible to the eye.

Not every gynecologist is a good colposcopist. An experienced specialist monitors the cervix during extended colposcopy after treatment with vinegar and iodine, literally without taking his eyes off, and makes very accurate diagnoses. By the way, in some countries it is the vinegar test, and not the PAP test, that is a screening method for diagnosing precancer. If coarse acetic-white epithelium is detected, the woman is taken under control and treated.

Hyperplastic epithelium- usually synonymous with cervical canal polyp. Needs removal and histological examination.

Cells with signs of keratosis, keratinization- most often these words can be seen in the conclusions of women with suspected leukoplakia. But the same signs (features of epithelial cells) occur in precancer and cancer.

Pronounced reactive changes- inflammatory process in the cervix.

Signs of mild dysplasia - lsil. If there are pronounced, profound changes, we are usually talking about HSIL - severe neoplasia, in which surgical intervention is necessary - conization of the cervix.

Koilocytosis - most characteristic of PVI (human papillomavirus, HPV). Viral infection.

Reparative changes in the epithelium- benign cell changes, a variant of reactive changes (see above).

Degenerative changes- this is not cancer, they occur during a chronic or acute inflammatory process. In the same category, reactive changes include the following concepts: inflammatory atypia, squamous metaplasia, hyperkeratosis, parakeratosis.

Atypia, atypical changes- dysplasia (precancer) or malignant neoplasm.

Atypical squamous epithelial cells of unknown significance– . These are cells of unknown significance. The cytologist sees that they look unusual and changed, but cannot accurately determine what caused this - inflammation, infection or irritation. There is no need to be afraid of this formulation. It does not raise the doctor's suspicion of cancer. However, it is a reason to take smears from the cervix for HPV of high oncogenic risk (required types 16 and 18). And if they are revealed, you need to go through.

Proliferation of squamous epithelium- that is, proliferation or in medical terms - mitosis. Normally, this process proceeds slowly. Its purpose is to renew the upper layer of the cervical mucosa. During pregnancy, the process is more active, but normally moderate.

If, according to the results of scraping, proliferation is pronounced, then this happened for one of the following reasons:

• cervicitis (inflammatory process on the cervix);
• tissue trauma resulting from diagnostic curettage, abortion, difficult childbirth, conization;
• tumor growth - benign or malignant (cervical canal polyp, mild or severe dysplasia, cancer, papilloma).

That is, proliferation can be hyperplastic, inflammatory or post-traumatic.

Discaryosis – . The cause is gynecological diseases (colpitis, cervicitis, vaginitis) or dysplasia.

When is treatment required?

1. For mild dysplasia (CIN I, lsil) Observation by a gynecologist, cytological smears and colposcopy are sufficient. In case of severe dysplasia (HSIL, CIN II, CIN III), conization is performed - surgical removal of the affected tissue. In some cases, doctors decide to amputate the cervix.
2. With reactive changes. Often a woman is diagnosed with the first degree of neoplasia (dysplasia) in question. Questionable because the cells can become “normal” again after antibacterial treatment.
3. If found keratinization of the epithelium - leukoplakia. We wrote about this in detail. “Cauterization” of a tissue area is carried out if the presence of leukoplakia is proven by biopsy.
4. If, according to the results of a general smear on the flora, not only squamous epithelium is noticed in large quantities, but also a lot of mucus, leukocytes, and the woman herself complains of unusual discharge, itching, unpleasant odor, etc.

The number of leukocytes in the visual field. to squamous epithelial cells

The number of leukocytes largely depends on the individual characteristics of the body and the day of the menstrual cycle (there are more of them during the period of ovulation), the presence or absence of sexual activity, and possible chronic cervicitis - inflammation of the cervix.

For this reason, doctors do not identify a specific norm for leukocytes. They only look at their ratio to the cells of the vaginal epithelium. The ratio of leukocytes to squamous epithelial cells should be up to 1:1. If the number of leukocytes to squamous epithelial cells increases to a ratio of 2:1, 3:1, 4:1 or more, this indicates an infection, often candidiasis (thrush) or trichomoniasis. 1:1 - borderline ratio. This is not necessarily an incipient disease. Perhaps the result was influenced by some chemical or mechanical factor. The same sexual intercourse if it happened a few hours before the smear test. That is, 15-20 leukocytes with 15-20 epithelial cells in the field of view may be a normal variant. This is especially common in pregnant women.

We bring to your attention a table from the guidelines for attending physicians. They can see that the number of leukocytes is greater than the number of epithelial cells in nonspecific vaginitis, candidiasis, and trichomoniasis. But with bacterial vaginosis, on the contrary, it is less.

Cytologists also pay attention to the structure of epithelial cells, their changes, and the ratio of their nucleus to cytoplasm. In disease, the cell nucleus is large. This is explained by the fact that the scraping contains cells from the lower layers of the epithelium. And the reason for this is the active desquamation of the surface epithelium due to an inflammatory reaction.

The rather complex process of diagnosing infections of the genital organs and genitourinary system most often does not allow the doctor to quickly and promptly prescribe the necessary treatment.

This is especially true oncological diseases, asymptomatic. Therefore, women of reproductive age are recommended to take a cytology test at least once a year.

The cytological smear also has other names, such as Pap test, cytology smear, Pap smear. This type of study is carried out during a gynecological examination, as a result of which the doctor suspects an anomaly. The test requires cell collection special brush tool from the walls of the vagina, from the cervical canal, and also from the cervix.

The procedure is carried out without special preparation and is painless for the patient. The resulting mucus is applied to a glass slide, dried and sent for examination. During the analysis, the drug is stained with special reagents and examined under a microscope. This determines:

• structures and sizes of cells;
• epithelium shape;
• number of cells per unit area;
• pathologies in cell structure;
• arrangement of cells relative to others.

A cytology smear allows you to determine the presence inflammation of the genitourinary system, development of tumors and the likelihood of developing precancerous epithelial pathologies. Squamous epithelium is a layer of cells lining the vaginal mucosa.

The upper layer of the mucosa consists of keratinized and non-keratinized cells. It is the presence of a large number of keratinized cells in the smear that can tell the doctor about diseases.

After taking a smear, a small amount is allowed bloody discharge in three days. If a woman’s condition worsens and her temperature rises, heavy bleeding, abdominal pain, and chills occur, she should immediately consult a doctor.

Normal squamous epithelial cells

The presence of squamous epithelial cells in the smear is normal, since the entire cervix is ​​covered with squamous epithelium. The normal volume of these cells in a smear can be up to 15 units in sight. The absence or greater volume of cells indicates the presence of abnormalities in the body. However, an accurate diagnosis can only be established by assessing all study parameters. A small number of squamous epithelial cells in a Pap smear (up to 5 per field of view) indicates insufficient production of estrogen in a woman’s body.

In medical practice, there have been cases when there are no squamous epithelial cells in a Pap smear. This indicates that they are atrophied. In addition, such cell death may indicate high likelihood of developing cancer. In this situation, in addition to the usual cytology test, the doctor recommends that the woman undergo additional tests to obtain more accurate results.

Inverse research results or an excessive increase in the number of squamous epithelial cells in a cytology smear (from 15 or higher in the field of view) is most often a sign of inflammation cervix, diffuse mastopathy or primary infertility. If there are benign formations in the genitourinary system or during hyperkeratosis, an increased number of squamous epithelial cells may also be observed. Hyperkeratosis is a violation of the keratinization process in the body. At the same time, the amount of squamous epithelium produced in the body is not controlled.

In addition to the number of squamous epithelial cells in the smear, dimensions and condition cells. All these data are evaluated to obtain accurate information about the woman's health.

The size and general condition of flat cells is studied according to indicators such as:

• form;
• structure;
• sizes.

Indicators consisting not only of flat epithelial cells, but also cylindrical and multilayer. Such research results can be observed if the smear collection procedure is not entirely accurate. Then cells from different layers of the epithelium enter it. However, the presence of cells with an abnormal structure in the smear may indicate that inflammatory processes are occurring in the uterus, including a high probability of the presence of papillomavirus, benign lesions of the cervix or dysplasia in the woman’s body.

Only a doctor can evaluate the results of the study and make a preliminary diagnosis based on the analysis.

Epithelial cells with and without atypia

Atypia is a special condition of cells. They have the wrong structure, and their shape, structure and dimensions are changed. This condition is one of the main signs of pathologies, including a high probability of developing cancer, since an atypical cell is a potential cell from which a tumor can form.

If atypical cells are present in a cytology smear, it is usually assumed that a woman has developed HPV, vaginal infections, or the process of degeneration of epithelial cells into squamous cell carcinoma.

Normally, atypical cells are not found in cytological studies. A PAP test is used to detect them. Based on its results, they calculate severity of atypia. Total exists 5 classifications.

With normal cytology in a person, its analysis is assigned first grade.

If there is a slight change in the morphological structure of cells that were affected by inflammation occurring in the body of the uterus or vagina, tests are obtained second class with an explanation, that is, what disease could cause atypia. This could be inflammation, tumor, condylomas, HPV.

Third class requires repeated examination, since the smear taken reveals cells with uncharacteristic abnormalities of the nucleus and cytoplasm. Dysplasia of several types can be observed: mild, moderate or pronounced.

Fourth grade suggests the presence in the analyzes of cells with an uncharacteristic enlarged nucleus of a non-standard shape, while its cytoplasm is also changed and signs of malignancy are observed.

Fifth grade call the results of a study in which the number of malignant squamous epithelial cells is significantly higher. In this case it is diagnosed invasive cancer.

If the study does not reveal atypical cells, then the diagnosis is established solely by measuring their number in the smear.

Cytological nasal smear

A cytological smear is prescribed for women not only if there is a possibility diseases of the genitourinary system. Quite often, this type of research is prescribed for studies of the nasal mucosa.

However, such an analysis is called a nasocytogram. Its task is also to study epithelial cells, as well as neutrophils, lymphocytes, monocytes, mast and plasma cells, and eosinophils. In addition, the characteristics of these cells are studied.

A nasal smear for cytology is carried out as follows. A special brush is used to collect epithelial cells from the lower nasal passage. In this case, the analysis is taken from both nostrils, therefore, the left and right halves of the nose are examined separately.

When evaluating the test, the quality and quantity of the cells obtained, as well as their composition, and possible signs of intracellular infections are studied. It is also important to count different types of cells in order to obtain comparative data that allows us to identify different diseases.

Indicators are considered normal nasocytograms in which a person’s smear shows a single number of neutrophils, single lymphoid elements, single eosinophils, a small number of anucleate cells of squamous epithelium, squamous epithelial cells themselves (up to 2% of the total cell volume), columnar epithelium.

Depending on the disease, the results of the study may show different results, according to which the doctor can assess your health status patient and, if necessary, prescribe other studies to confirm the disease.

A clear example of damaged endometrium

Atypia, what is it in gynecology, is a question that a woman of any age may unexpectedly need an answer to. The term itself is generally clear; it corresponds to something incorrect, unnatural, i.e. not typical, but how this is connected with the female body and how dangerous it is requires a more detailed consideration.

What is meant by “atypical” in gynecology?

When speaking about atypia, gynecologists mean a variety of disorders that occur in the tissues of the female reproductive system at the cellular level. Essentially, this is the formation of abnormal cells, which manifests itself in a distortion of their structure and is accompanied by a number of signs indicating problematic malfunctions in the body, improper functioning of an organ or the entire reproductive system.

Carefully! Despite the fact that this condition is not yet oncology, it is recognized as precancerous, i.e. capable, under certain conditions, of giving rise to the onset of cell malignancy. Therefore, it is subject to urgent and mandatory treatment.

Most often, pathology develops on the cervix, because this part of the organ is primarily exposed to the adverse effects of external factors (viruses, bacteria, infections), the development of inflammation and other damage. As a result, when normal cells divide, atypical ones are formed, i.e. having an irregular structure, abnormal shape and size.

Interesting! In the human body, abnormal cells are formed too often, but if the immune system is healthy, then it immediately destroys them, preventing the occurrence of pathological formations.

Cellular disorders in the tissues of the cervical walls and cervical canal can provoke the rapid development of abnormal layers. This in turn causes disturbances in the functioning of the organ. In addition, there is often a deterioration in blood circulation in these areas, which leads to the occurrence of such a type of atypia in gynecology as vascular, i.e. to distortion of blood vessels, which can enlarge and proliferate.

The described pathological processes often develop directly in the uterus; they can be closely related to endometrial hyperplasia (the internal mucous membrane of the organ).

Endometrial hyperplasia and what it is

Hyperplasia is understood as a thickening of the layer of the inner mucous membrane of the uterus, which occurs with a violation of the ratio of glandular tissue and stromal tissue. The endometrium always reacts to changes associated with the cycle; in the first phase it grows, and if pregnancy does not occur, it is destroyed, and excess fragments leave the body with menstrual blood. When the hormonal balance is disrupted (increased estrogen synthesis and decreased progesterone levels), the proliferation of glandular cells continues, which leads to pathological proliferation. In gynecology, there are different types of this disease:

Read also: Radiation therapy for cervical cancer: reviews

Simple endometrial hyperplasia

Without the formation of atypical cellular structures. It is characterized by the proliferation of glandular tissue. With it, the boundary between the basal and functional layers of the mucosa can gradually disappear, but the boundaries with the myometrium are not affected. The absence of atypical structures makes this form non-life-threatening, but it is accompanied by a number of symptoms that bother the woman

Complex

As a rule, it is accompanied by structural changes, an increase in glandular elements and a decrease in stromal elements, the development of nuclear polymorphism and the appearance of cells with signs of atypia. This type of disease is the most dangerous; it has a high tendency to malignancy, therefore it is considered as a precancerous condition and may require surgical intervention

What can trigger the onset of atypical changes

Like any pathological processes, cell atypia is also not causeless. One of the main factors is hormonal disorders in the body, which is confirmed by the fact that most often pathologies develop in women 40 years of age and older, whose bodies begin to prepare for the menopause.

No less dangerous is the presence of factors such as:

• frequent gynecological diseases;
• having promiscuous sex life;
• injury to female organs (numerous abortions, wearing an intrauterine device);
• the course of chronic inflammatory processes;
• presence of HPV in the body;
• weakened immune system;
• too early onset of sexual activity;
• heredity.

How can the course of a pathological process manifest itself in the body?

Gynecological diseases and disorders usually present with symptoms that disrupt a woman's life and cause significant discomfort. Depending on the degree of development of the pathological process, the characteristics of the disease and its development, signs of atypia may be:

• disturbances of the menstrual cycle, its frequency and duration of menstruation;
• bleeding;
• painful menstruation;
• the appearance of spotting in the middle of the cycle, as well as continuing long after menstruation or occurring after sexual intercourse;
• problems with conception (infertility).

Very often, descriptions of cases of atypia in gynecology note that this is a phenomenon that can be asymptomatic. In the early stages, the absence of signs is almost always observed, so the disease can be detected only by diagnostic results.

How is the pathological process diagnosed?

To diagnose the pathological process, a gynecological examination is performed with colposcopy and smear collection for atypia. In the first case, we are talking about a visual study of the surface of the organ through a special optical device - a colposcope, and in the second - a laboratory study of scraping the epithelium from the affected areas, which is taken using a gynecological spatula or brush directly during examination with mirrors. Both procedures are completely painless.

Taking an analysis to identify the presence of pathology

The taken smear is sent to the laboratory for cytological examination. To establish for sure that this is cervical atypia, an assessment method such as PAP (or Papanicolaou cytogram) is used. The biomaterial is stained and then examined under a microscope for its cytoplasmic and nuclear structure:

• the type of pathological process is initially determined (it can be inflammatory, malignant);
• then the severity of atypia is determined;
• then differentiation is carried out between epithelial fragments.

Read also: Cervical ectopia: what is it

What the results report and how they are noted in the conclusion

Based on the results of the cytological examination, a decision is made on further treatment. If the biomaterial reveals that it is squamous epithelium without atypia, then the conclusion of the study will indicate class “1”, and this is considered normal and does not require treatment. If the mark is “2”, we can say that no atypical changes were found in the epithelium, and small deviations in the morphology of cellular elements indicate the development of inflammatory processes. If single abnormal cells are found in the cytoplasm and nucleus, then the laboratory report will indicate Papanicolaou class 3, and in this case, a more detailed study is recommended (through a biopsy or a repeat cytology smear). Class “4” means that multiple atypical nuclei are found in the smear, and there are abnormalities in the cytoplasm. Class “5” is given in the most difficult cases, i.e. when detecting invasive cancer.

Attention! The Pap test detects a precancerous condition in 80% of cases, so all women should undergo it annually, especially after 25 years.

Among the diagnostic results, a note about the result according to the Bethesda system classification may be given; in this case, the division is divided into changes:

• benign, in which no atypical changes in the structures of the epithelium are detected, but viruses (for example, herpes), inflammation, fungi, cocci can be detected;
• undetermined ASC US. Atypical structures were discovered, i.e. in this case we are talking about the development of a precancerous condition;
• malignant in nature, i.e. invasive (squamous cell) cancer.

What treatment options are available?

What treatment will be prescribed depends on many factors: the type of pathology, the neglect of the process, the presence of concomitant diseases, possible causes of the development of disorders, and the age of the patient. It could be:

• medicinal;
• operational.

Surgical intervention is necessary in a complex stage of pathology development

Drug therapy is appropriate at the initial stages of the process, when atypical cells and vessels do not disrupt the functioning of the organs of the reproductive system, which does not cause concern to the woman. Its goal is to normalize hormonal levels, eliminate inflammation and other pathologies, normalize vaginal microflora, strengthen the immune system, and stop abnormal processes.

With a more complex degree of development of the pathology, they resort to surgical intervention, which can be in the form of:

• removal of affected tissue with a laser beam;
• cryodestruction;
• cauterization with electric current;
• radio wave exposure.

The greatest effect is achieved by combining these methods. Complete removal of the organ is possible for women who do not plan to have children in the future, with advanced processes and with the onset of cell malignancy.

Knowing what atypia is in gynecology and what consequences structural disorders at the cellular level can lead to, the need to undergo qualified treatment, instead of experimenting with traditional methods, should not raise doubts. It must be adequate and timely.

oncology24.ru

Cytology, what is it?

Cytology is a method of examining tissue material taken from a patient to determine its cellular composition. After special treatment, the cellular structure of the area of ​​the body being examined is studied to determine the presence or absence of pathological cells.

In gynecology, the oncocytology analysis method is widespread and is used to study the cervix for the purpose of early diagnosis of cancer. An analysis such as cervical cytology serves as a screening and allows you to detect pathology at an early stage.

Atypia

What is cervical cell atypia? This term means that for one reason or another, the normal cellular composition on the surface of the cervix in the vagina or in the cervical canal is disrupted.

Another name for this process is dysplasia. This condition has a complex development mechanism and is dangerous because it can cause cancer.

Causes

It is known that atypical cells appear in the cervical mucosa under the influence of various and often concomitant reasons. Development factors include:

1. An infectious process caused by the human papillomavirus.
2. Sexually transmitted diseases.
3. Genetic predisposition.
4. Adverse reactions to hormonal or other drugs.
5. Promiscuous sexual intercourse.
6. Smoking.
7. Hypovitaminosis.
8. Immunodeficiency.

It is no coincidence that the first place among the listed causes is the human papillomavirus (HPV). It is this infectious disease that is the main factor in the development of cancer in this anatomical region.

A vaccine against HPV has been developed and is being used, which is highly likely to prevent the development of atypia.

Degrees

In its development, cellular dysplasia has a number of successively changing stages. The following degrees of the disease are distinguished:

• Mild: there is a proliferation of cells in the deep layers of the cervix. Superficially located rows remain healthy.
• Moderate: hyperplasia of all layers of the mucosa. Sometimes single atypical cells are found.
• Severe: pronounced changes in the entire thickness of the mucous membrane. Structural elements increase in size, increased brightness of intracellular structures is observed - hyperchromia.

The last stages of the disease are defined by some experts as a group of cancer diseases that require urgent therapeutic measures.

Indications for smear cytology

A cytological examination of smears of the cervical mucosa is performed on all healthy women over the age of 18 years. In addition, the analysis must be carried out unscheduled in the following conditions:

1. Preparing a woman for pregnancy.
2. Identifying the cause of infertility.
3. Deviations in the menstrual cycle.
4. Sexually transmitted diseases, such as herpes in the genital area.
5. Human papillomavirus infection.
6. Before installing intrauterine contraceptive devices - spirals.

Even in the absence of the listed indications, cytological examination should be carried out regularly to exclude atypia of the cells of the cervical mucosa.

Material collection procedure

In order to examine the tissue being examined under a microscope, it is necessary to collect material - a smear or scraping. This is precisely the procedure for taking a section of the cervical mucosa for examination for oncocytology.

Many people have questions: how exactly does manipulation occur and should one prepare for it? It is worthwhile to dwell on these points in more detail.

Preparation for the procedure

If you have been prescribed the described procedure, you should follow a few simple conditions in order to conduct the study painlessly and obtain reliable materials.

1. Abstain from sexual intercourse two days before visiting a gynecologist.
2. 2 days before the procedure, you should not use vaginal forms of medications - gels, suppositories, creams, etc.
3. Two hours before the gynecological examination and procedure, you should not urinate.
4. If you experience unpleasant symptoms from the genital organs: pain, itching, discharge, you should inform your doctor. Some conditions may be a contraindication for a smear for oncocytology.

The optimal time for submitting material for cytology is the period after menstruation (approximately the fifth day of the cycle).

Taking technique

Cytology in gynecology involves taking material through a mucosal smear. The scraping is performed in a gynecological chair during a doctor’s examination. Using special sterile instruments (cytological brush), a layer of tissue is taken from the vaginal part of the cervix and from the cervical canal. Cytology is a low-traumatic procedure, therefore it is used for mass diagnostics.

The gynecologist tries to take material at the border of healthy tissue and the expected site of atypia, so that the doctor in the laboratory can detect altered cells.

In most cases, the procedure lasts a few seconds and is absolutely painless for the patient.

Sometimes there is bloody discharge from the vagina, the appearance of which is associated with minor trauma to the mucosal area. This side effect of an oncocytology test usually lasts for two days and does not require special treatment methods.

Complications

The use of disposable sterile instruments, taking material from the very edge of the cervical canal, and compliance with the requirements for the manipulation reduce the risk of complications to a minimum. However, even such a safe procedure as cytology can lead to complications.

If after the procedure you experience pain and bleeding from the vagina for more than two days, you should consult a gynecologist for examination.

It is possible that the smear technique was violated when collecting material for oncocytology.

A serious complication of the procedure is stenosis of the cervical canal. This condition is characterized by overgrowing of the lumen of this anatomical area with adhesions. This reaction of the body is associated with extensive or deep trauma to the mucous membrane, in response to which healing occurs with the formation of scars. This condition can lead to infertility, as the cervical canal becomes obstructed.

The risk of complications is minimal, so cytology is the most important method in the primary diagnosis of cervical cell dysplasia.

Liquid cytology of the cervix

The most effective method of preparing the material taken for examination is liquid cytology of the cervix. This technique allows us to achieve a minimum frequency of false-negative cytological findings.

An analysis of cervical cytology performed by this method has a number of advantages over a traditional smear for oncocytology:

1. The use of special tools and containers can improve the quality of the material.
2. The smear contains a minimum of mucus and blood destroyed when scraping cells.
3. Ideal conditions for storing the material in solution, preventing cells from drying out.
4. Maximum speed of preparing a specimen for microscopy for oncocytology.
5. Several preparations can be prepared from one smear.
6. Special staining that allows maximum visualization of cells.

When using traditional methods of preparing and staining material for research, elements of inflammation, blood and mucus enter the field of view of the laboratory technician, which interfere with the vision of atypical and cancer cells. Liquid cytology of the cervix improves the quality of the material and minimizes the likelihood of a false result.

Interpretation of analyzes

Material taken for oncocytology research is most often prepared within 1 day. However, if the laboratory is busy or special methods of preparing the drug are used, the results of the study will take longer to prepare.

The transcript of the study shows the presence or absence of changes in the mucous membrane of the cervix.

If, when examining the prepared preparation, a laboratory technician discovers that all cells have the same shape and size corresponding to the norm, such an analysis is assessed as normal.

However, when deciphered, cytology tests may reveal phenomena of hyperplasia, atypia of mucosal cells, and the presence of cancerous elements. In this case, the degree of deviation is determined. The transcript may contain the following conclusion:

• CIN 1 – mild dysplasia.
• CIN 2 – moderate dysplasia.
• CIN 3 – severe dysplasia, cellular atypia.
• Cervical cancer.

The diagnosis of dysplasia does not necessarily mean that cells become cancerous. It is necessary to adhere to the recommendations of the gynecologist to prevent the development of the oncological process.

Further diagnostics

Deciphering cytology shows the gynecologist changes in the mucous membrane, which may serve as an indication for further diagnosis.

If, after receiving cytology tests, deviations in the structure of the mucosa and even the presence of cancer cells in the preparation are detected, further diagnostics are necessary to confirm the diagnosis.

The first step in clarifying the patient’s condition is repeating the cytological analysis after a certain period.

Further diagnosis may involve colposcopy with a biopsy of the cervical mucosa.

This procedure involves a visual examination of the vaginal cavity using a magnifying colposcope by a gynecologist. During such a study, a specialist detects suspicious areas of the mucous membrane of the cervix using special dyes and takes the material for examination.

Such a procedure is more valuable in diagnostic terms than a smear for oncocytology, as it allows for targeted sampling of suspicious material and more reliably shows atypia of cervical cells.

flovit.ru

Cervical smear: necessary prevention

A cervical smear allows the gynecologist to analyze the condition of the cervical mucosa. During the natural process of movement of cell layers, there is a possibility of cell damage. A cervical smear can determine the extent of tissue damage and prevent the development of uterine cancer.

"Abnormal" cervical smear results show changes in cells in the cervical area. In some cases, such changes indicate the development of cervical cancer - although “abnormal” test results are not always associated with the presence of cancer.

Regularly undergoing such tests can significantly reduce the likelihood of developing cervical cancer.

Atypical cervical mucosal test results may be due to various factors. Among them:

Infections

• Trichomonas vaginalis
• Fungal microorganisms
• The presence of a large number of coccobacilli in the vaginal environment
• Bacterial vaginosis
• Cellular changes associated with herpes simplex virus

Reactive cell changes may be associated with:

• Inflammation
• Atrophy
• Radiation
• Intrauterine contraceptives

Epithelial cell abnormalities are associated with:

• Atypical squamous epithelial cells of unknown significance
• Low grade squamous intraepithelial lesion
• High grade squamous intraepithelial lesion
• Epidermoid cancer

What does an abnormal cervical smear result mean?

To determine the results of a cervical smear analysis, the Bethesda classification is most often used, which provides a number of special categories to characterize the results. One of these categories is the degree of intraepithelial damage, which characterizes precancerous changes in the cells of the cervix. Such cells are flat and have an irregular shape.

An abnormal cervical smear result may mean:

• Cervical dysplasia: Cervical smears can sometimes detect cervical dysplasia or intraepithelial neoplasia, which precede the development of cervical cancer. Dysplasia is characterized by mild (CIN 1), moderate (CIN 2) or severe (CIN 3). Mild forms of dysplasia often go away on their own and do not require any treatment, while moderate and severe forms of the disease require further investigation and treatment.
• Atypia of squamous epithelium: Atypia of squamous epithelium (ASC) is another possible result of a cervical test. ASC can be of two types. ASC US refers to non-serious changes in epithelial cells that can be caused by a vaginal infection or the human papillomavirus. As a rule, if such results are obtained, the cervical smear is repeated. ASC H indicates the possibility of squamous intraepithelial lesion, which results in some epithelial cells in a precancerous stage. When such results are obtained, colposcopy is usually recommended to more accurately examine the cervix.
• Atypia of glandular cells (AGC): refers to the abnormal development of mucus-producing cells located in the cervix or uterine cavity. This result of a smear from the cervix shows that the cellular changes are quite serious - women with atypia of glandular epithelial cells have a much higher chance of developing cervical cancer. Typically, colposcopy is recommended to analyze abnormal tissue.
• Intraepithelial lesions are associated with human papillomavirus, a common type of sexually transmitted disease. The risk of infection by the human papillomavirus is highest in women under 20 years of age. In most cases, the body's immune system copes with the virus itself, but in some cases, infection with the papilloma virus leads to the development of cervical dysplasia. The chance of developing cervical dysplasia as a result of the human papillomavirus in women who smoke is twice as high as in women without the bad habit.

High-grade intraepithelial lesion (HSIL) is characterized by the presence of cells that are different in shape and size from normal. These cells are usually at a precancerous stage and can lead to the formation of cervical cancer.

If a cervical smear shows the presence of abnormal cells, this indicates the presence of cancer cells in the tissues of the vagina, cervix and uterine cavity. Usually, with such results, additional tests are recommended.

If a cervical smear shows inflammation, this may mean there are red blood cells in the smear. Inflammation of the cervix is ​​a fairly common phenomenon, so, as a rule, doctors investigate the cause of inflammation only in the most serious cases. If inflammation is detected, a repeat cervical smear is recommended to check the nature of the inflammatory process.

Hyperkeratosis means the presence of dead cells in the smear. This type of cellular change may be associated with certain cervical infections, as well as with the use of a cervical cap and other intrauterine devices. For hyperkeratosis, a repeat cervical smear is recommended within six months. When re-diagnosing hyperkeratosis, colposcopy is performed.

Article tags:

• uterine examination methods

www.womenhealthnet.ru

Cervical analysis - taking care of your health

Cervical tests are one of the main methods for diagnosing the condition of the female genital organs. Many cervical pathologies 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 cervical cytological analysis and cervical biopsy analysis.

Cytological analysis of the cervix

To conduct this study, a smear is taken from the woman for analysis of the cervix.

A cytology smear (PAP test, Papanicolaou smear) is a cheap, simple and fairly accurate gynecological examination method that allows you to determine the condition of the cervical tissue. Using a cytological smear, you can identify abnormal (atypical) cells that can degenerate into malignant ones. The smear is an absolutely safe and painless procedure.

Experts recommend that all women begin to undergo a cytological analysis of the cervix three years after the start of sexual activity, but in any case no later than 21 years. Women aged 21–49 years should undergo this examination every three years, and women aged 50–65 years – once every five years.

Cytology analysis is the most accessible and simple way to diagnose cervical cancer and dysplasia (precancerous conditions). Regular testing is necessary for women suffering from human papillomavirus or genital warts. This is due to the fact that these diseases most often provoke the development of cervical cancer.

It is very important to properly prepare for a smear test for the cervix.

Firstly, a smear is not taken during menstruation and in the first few days after its end, in case of inflammatory diseases of an infectious nature. Secondly, two days before the analysis, you must stop using vaginal tablets, suppositories, sprays, douching, and intimate hygiene products. Thirdly, you need to abstain from sexual intercourse two days before the study.

A cytology smear is taken during an examination of a woman in a gynecological chair. First, the doctor, using a cotton swab, cleans the surface of the cervix from secretions. After this, using a special brush, the material for analysis is taken and 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 material for bacteriological analysis, which is used to determine the microflora of the cervix and vagina.

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 taking a cervical test, a woman is not recommended to have sex, douche, or use vaginal tampons.

The results of a cervical smear cytology test are normal (“negative”, “good”) when they indicate the absence of serious changes in the cervical mucosa. Abnormal smear results (“positive”, “bad”, “dysplasia”, “atypia”) indicate that changes have been detected that can lead to the development of cancer.

There are many factors that can cause changes in the condition of cervical epithelial cells. The most common cause is the human papillomavirus and many other sexually transmitted infections (ureaplasmosis, chlamydia).

But there is no need to take poor smear test results as a death sentence. If deviations from the norm are detected, the doctor will prescribe additional tests, usually colposcopy (examination using a colposcope). After this, if necessary, the patient is prescribed an additional test - a cervical biopsy.

Cervical biopsy test

A cervical biopsy is the cutting (excision) of a piece of tissue from the cervix for microscopic examination. A biopsy can be diagnostic (performed to make or clarify a diagnosis) and therapeutic (performed to monitor changes in tissue during therapy).

Analysis of the cervix using biopsy is more accurate than cytology. 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 the atypical cells are pathological and how severe the changes are. Thanks to this study, the specialist selects the necessary treatment method for the patient.

A cervical biopsy can be performed in the following ways:

• pinched – performed with special biopsy forceps; wound healing occurs within 3–4 days; low-traumatic and quite informative method;
• radio wave (loop) – produced by a radio wave loop; a method that is absolutely bloodless at the time of material collection; slight bleeding occurs a week after the biopsy;
• conization - excision of a tissue fragment in the form of a cone; used not only for diagnosis, but also to remove the pathological area of ​​the cervix.

For each specific patient, the doctor selects the optimal biopsy method. This procedure is carried out 3–5 days after the end of menstruation. Before the biopsy, the woman is sent for blood tests for HIV infection, hepatitis, and syphilis.

A cervical biopsy is performed on an outpatient or inpatient basis. Since this procedure is often performed under anesthesia, it is not recommended to eat anything 12 hours before the procedure.

The material is collected from a woman lying on a gynecological chair. After the biopsy, the doctor treats the wound surface with a special coagulant solution, which accelerates blood clotting. The results of this analysis are usually ready within 10–14 days.

After the biopsy, a woman may have nagging pain in the lower abdomen for five days, and spotting may be observed for ten days.

In order to minimize the unpleasant consequences of a biopsy, a woman needs to adhere to certain rules after it is performed for 4–8 weeks:

• exclude significant physical activity;
• do not lift weights exceeding 3 kg;
• do not use vaginal tampons, avoid douching;
• refrain from visiting swimming pools, baths, saunas;
• take only a shower and never a bath;
• abstain from sexual intercourse;
• Take medications that thin the blood, such as Aspirin, with caution.

The results of this cervical analysis fully reflect the degree of damage to the entire thickness of the cervical tissue. Based on them, the doctor will be able to select the most appropriate therapy that will help restore the woman’s health.