Cytological examination of the cervical canal or pap-test in women
How to analyze
Cytological smear (Pap test, Pap test, smear on oncocytology) is performed at the gynecological examination. A doctor examines the vagina, the entrance to the cervical canal and the cervical mucosa with the help of a mirror. If there are suspicions of an anomaly, cells are taken by a special brush from 3 areas: from the walls of the vagina, the cervical canal, the entrance of the cervix. The procedure is comfortable, painless and does not require special preparation.
- cell structure;
- cell size;
- epithelial form;
- mutual arrangement;
- the number of cells per unit area;
- pathological changes in the structure of cells.
A smear on cytology allows to determine the majority of inflammatory diseases, precancerous epithelial pathologies (dysplasia), and malignant tumors. After taking a smear, bloody discharge is often observed within 2-3 days, which is the norm. Extremely rare - severe bleeding, abdominal pain, chills, fever. In this case, an urgent examination by a gynecologist is required.
When an analysis is prescribed
Ideally, every woman can pass the study on cytology regularly, without any instructions the doctor. A routine gynecological examination can reveal the presence of inflammatory processes in the cervix and cervical canal. Cytological smear is only a method for confirming a diagnosis. Therefore, it is better to follow the recommendations of the gynecologist - if there are no indications for analysis, then you should not worry too soon.
Nevertheless, a study on cytology should be carried out by women under the age of 40 years - 1 time per year, older - 2 times a year and more often. Cases in which cytology assigned mandatory:
- in violation of the menstrual cycle;
- in inflammatory processes of the cervical canal, cervix, etc., especially chronic;
- in violation of reproductive function;
- during pregnancy planning;
- before surgery and other medical procedures;
- before installing the intrauterine device;
- taking hormone-containing drugs;
- obesity 2, 3 degrees;
- the presence in the body of the papilloma virus, herpes genital;
- active sex life of women with frequent changes of partners.
How to prepare for the analysis
To ensure the maximum degree of cleanliness of the smear, you should follow the rules before going to the gynecologist:
- Do not use local drugs (vaginal swabs, suppositories, ointments).
- Do not douching.
- Wait until the end of the month.
- In case of inflammatory diseases with copious secretions, you should first carry out a general treatment. After the control smear, confirming the recovery, you can start the analysis of cytology.
- 3 hours before cytology can not urinate.
- It is better to abstain from sexual intercourse 2 days before taking the secret.
Compliance with these rules will allow you to avoid unnecessary anxiety and re-visit the doctor.
What can reveal cytological analysis
How to decipher smear on oncocytology? Decoding data obtained in the laboratory, is available for understanding only by a doctor. And not always the gynecologist gives a detailed picture of the disease, not wanting to waste time on explanations.
In the research process, you can get 5 results:
- 1 type of cell change or a negative indicator. This conclusion is made when cytological examination revealed no abnormalities, and the woman is healthy.
- Type 2 changes or inflammatory nature of the disease. In this case, additional tests are prescribed to accurately determine the nature of the changes and the reason for causing them. After treatment, after 3 months, a second smear is recommended for cytology.
- 3 type of changes or the presence in the epithelium of single cells with an abnormal structure of the nucleus. The patient is sent for detailed histological and microbiological examination.The final diagnosis is made on the basis of additional data, as well as on the basis of a smear on cytology, conducted 3 months after the first one.
- 4 type of change or suspicion of a malignant neoplasm. Morphological signs of cancer require urgent treatment, a full examination, including colposcopy, biopsy.
- Type 5 changes or identification of typical cancer cells in the epithelium in large numbers. Atypical cells found in the environment of the cervical canal and cervix, according to all signs suggest the presence of dysplasia and require immediate treatment by an oncologist. To determine the degree of damage, the nature of cell changes, prescribe a biopsy, histological examination.
2, 3, 4 type of changes identified in the study of cytology, may be a sign of disease:
- ectopia (erosion) of the cervix;
- human papillomavirus infection;
- genital herpes;
- parakeratosis of the cervix;
- bacterial vaginitis;
- vaginal candidiasis, etc.
Deciphering the result
Deciphering the results of the analysis for the doctor is a simple matter, for the patient these are incomprehensible letters and terms.
- Latin letters U, C, V - the symbol for the collection of secretions from the urethral, cervical canal and vagina, respectively.
- The number of leukocytes - the norm is the number of up to 15 units.
- The presence of Trichomonas, gonococci, fungi speaks of an infection of the genital organs that needs to be treated.
- Gardnerella in conjunction with the fungal mycelium are signs of vaginal candidiasis, which can cause inflammation.
- The presence of glandular, flat, cylindrical epithelium in large quantities with signs of atrophy, pathological changes suggests possible signs of the development of cancer. Such cells are carefully studied and described in detail in the comments. Sets the type, nature of the change.
- The degree of purity - 1, 2 degree indicates a good vaginal environment, 3, 4 requires additional research and treatment.
- Squamous epithelium is normally up to 10 units.Excess suggests a possible disease of hyperkeratosis - a benign cervical formation.
- Moderate mucus is the normal state of the vaginal environment.
If atypical cells are found in the smear, in conclusion, the laboratory technician will write about this and determine the type of changes. Therefore, if decoding cytology smear does not contain special notes, then most likely, no pathologies were found.
The time of the smear on cytology from 1 to 5 days. Pathological changes in cells of the cervical canal and cervix on the way to the diagnosis of "cancer" goes through several stages, and not in 1-2 days. Cytological examination allows you to identify atypical cells at the initial stage and start treatment, which in most cases leads to complete recovery. Therefore, cytological examination is universally introduced into medical practice as a quick, painless and inexpensive way to diagnose cancer cells at an early stage.