Cytological examination of the cervix and cervix. Examination of smears for cervical cytology: interpretation. Deciphering a smear for cytology using the Betsed method

In the vast majority of cases, leukocytes in a smear are a sign of an inflammatory process in the organs of the urogenital tract, both female and male. However, it is a rare man, especially at a young age, who can “boast” that he had a smear taken if everything is in order with the genitourinary system. For men, smears are not mandatory tests during medical examination. Another thing is women. Probably, there are no such people who are not subjected to such manipulations at least once a year. And this is in the absence of pathology, but if there are problems, then smears are taken as needed.

Norm and pathology

Normally, material from the male urethra is not abundant. Single leukocytes, transitional epithelium in a smear, single rods - that’s all that a healthy man can provide us with. The appearance of a large number of leukocytes in a smear of the stronger sex is usually accompanied by the presence of the culprits of inflammation(, yeast-like fungi of the genus, etc.), which is treated, and then analyzed again to ensure the success of the measures taken.

As for women, an increased number of white blood cells is observed before menstruation and is considered an absolutely natural phenomenon. In addition, the increased content itself (the norm is up to 30 cells in the field of view) is not considered a reliable indicator; the absence of leukocytes is considered evidence of a normal leukocyte level. morphological characteristics these cells. They are “quiet”, not destroyed (the nuclei are preserved), there are no signs of phagocytosis. In addition, sometimes the reason for the diagnostician’s confusion may be incorrectly taken material. An example is a “thick” smear, which is practically invisible due to the fact that the entire field is dotted with clusters of overlapping cells (including leukocytes). Without the risk of making a mistake, in such cases the woman is offered to take the test again.

Table: normal smear results for women

V – vaginal material, C – cervical canal(cervix), U – urethra

Flora and cytology - what is their difference?

If in men the analysis is taken only from the urethra, then in women there are more objects of study: urethra, vagina, cervix, cervical canal. True, sometimes they take an aspirate from the uterine cavity and also make smears, but this is considered biopsy material, which is reviewed by a cytologist. He also makes a conclusion. Aspirates are not taken during preventive examinations; this analysis is used exclusively for diagnostic purposes to identify cancerous and precancerous diseases of the main reproductive organ in women. In addition, if the aspirate is filled with formaldehyde, and then applied to glass and stained, you will get a histological preparation, which is considered the last resort in the diagnosis of malignant neoplasms.

Probably many have heard the expressions: “smear for flora”, “smear for cytology”. What does all of this mean? How are they similar and how are they different?

The fact is that in a smear on the flora at high magnification with immersion, the doctor can count the cells, detect trichomonas, yeast, diplococci, gardnerella and other microorganisms that represent the rich biocenosis of the female reproductive system. But he will not be able to determine morphological changes in the epithelium, since these are different areas of laboratory diagnostics, where cytology occupies a separate niche. The study of the cellular composition of some material requires, in addition to certain knowledge, also special training. The study of pathological changes in the cell and nucleus gives very little theoretically; here, as they say, a trained eye is needed.

The doctor deciphers the analysis in both cases (flora and cytology); we only have to become slightly familiar with some concepts so that, when faced with a similar problem, we do not get scared or panic.

Cytological examination

The tasks and functions of cytology are much wider, and therefore its capabilities are also wider. The doctor examining the material focuses on the condition of the epithelial cells in order to identify pathological processes (inflammation, dysplasia, malignant neoplasms) and at the same time notes the flora. Most often, the vaginal portion of the cervix, represented by multilayered (four-layer) squamous epithelium (MPE) and the cervical canal, is subject to examination. With a correctly taken smear from the cervical canal, the normal cytological specimen clearly shows the prismatic (cylindrical) epithelium, single leukocytes and depleted microflora, which could have come from the underlying sections (from the vagina, for example).

It should be noted that the cytological preparation is more informative, since the staining method (Romanovsky-Giemsa, Pappenheim or Papanicolaou) gives a clearer picture. The cells are viewed first at low magnification to assess the general condition of the specimen, and then at high magnification (with immersion) in order to examine not only the epithelium itself, but also changes in the nucleus characteristic of a particular disease. In a word, the cytologist sees the flora, inflammation, and in most cases its cause and the changes that this inflammatory process entailed. As well as indicative signs of infections that present particular difficulties in diagnosis, pre-tumor and tumor states of the epithelium.

Video: about a smear for oncocytology

Indirect signs of some STIs in cytology

As for the smear for STIs, it is advisable to examine it as a cytological preparation. A smear taken on the flora and stained with methylene blue is the most important, accessible and cheap, and therefore the most common diagnostic method in gynecology. However, unfortunately, it does not provide the necessary completeness of the picture for the diagnostic search for STDs and their consequences.

In addition to all possible inhabitants, which, when infected or disrupted biocenosis, are visible in a smear on the flora (Trichomonas, yeast, leptothrix), in the material under study (cytology) one can find indirect signs of the presence of microorganisms, which are very problematic to identify using microscopic methods:

• The appearance of giant multinucleated MPE cells, sometimes quite bizarre in shape, often with signs of parakeratosis and hyperkeratosis (keratinization), indicates a possible lesion;
• Cells in the form of an “owl’s eye” with coarse-grained cytoplasm are characteristic of;
• When you can detect koilocytic atypia (MPE cells with large nuclei and a clearing zone around the nucleus);
• Provacek bodies in the cells of metaplastic epithelium, which are characteristic of and play a role in screening studies, are also indicative.

Of course, it is impossible to make a diagnosis of herpetic, cytomegalovirus or papillomavirus infection by cytological analysis, but it can be assumed, and this is the basis for further, more in-depth examination in a specific direction (, etc.). Thus, cytology allows you to narrow the diagnostic search, avoid unnecessary tests, save time, and quickly begin treatment measures.

How to properly prepare for the analysis?

Since the simplest and accessible method To identify inflammatory processes of the urogenital tract, both in men and women, is a smear on the flora, then it is necessary to pay more attention to it and teach the reader to understand a little about the entries entered in the form.

However, before you visit your doctor, Patients should know some simple rules:

1. A couple of days before the test, it is necessary to exclude not only sexual contact (sometimes sperm can be seen in a woman’s smear), but also any interventions such as douching, the use of topical medications (suppositories, creams, tablets);
2. You should not go for such a study during menstruation, because menstrual blood will interfere with viewing the drug, where the doctor will mainly see it;
3. On the day of the examination, you need to calculate the time so that you urinate for the last time 2-3 hours before, since urine can wash away all the “information”;
4. 7-10 days before the test, stop taking pharmaceuticals, especially antibacterial drugs, or take a smear only a week after the end of treatment;
5. Another rule that women often ignore: do not use products intimate hygiene. Of course, it is very difficult to abstain from such procedures altogether, as experts recommend, but you can at least limit yourself to clean warm water. Men perform the last toileting of the external genitalia in the evening before visiting the doctor.

After following these tips, the person goes to an appointment, where they will take a smear, paint and look under a microscope. The doctor will do the decoding, and the patient will receive a conclusion, and he will probably be interested to know what all these numbers and words mean.

Video: preparing for a smear

What can be seen in a urethral smear in men?

The reader probably guessed that taking a test from men is unlikely to leave pleasant memories, because the object of study is not so accessible to them, so there will indeed be discomfort, which may not leave a person for several more hours. Sometimes, to avoid this, the doctor prescribes a prostate massage to the patient, which is performed several days before the procedure per rectum, that is, through the rectum.

However, if the burning sensation and soreness in the penis continues to remind itself for several days, and these phenomena are also supplemented by similar ones, a trip to the doctor is inevitable. But if everything went well, then perhaps men will be reassured by the fact that in their smear taken from the urethra, everything looks much simpler, unless, of course, normal analysis:

• The norm of leukocytes is up to 5 cells in the field of view;
• The flora consists of single rods;
• The general background dilutes the urethral epithelium (mainly transitional) - approximately 5-7 (up to 10) cells;
• A small amount of mucus that does not play any role;
• Sometimes a smear may contain opportunistic flora in single specimens (streptococci, staphylococci, enterococci), but in order to differentiate it, it is necessary to stain the smear using a Gram stain.

In the case of an inflammatory process, the smear changes:

1. A large number of leukocytes appear in the smear, sometimes not countable;
2. Coccal or cocco-bacillary flora displaces rod flora;
3. The drug contains microbes that cause inflammation (Trichomonas, gonococci, yeast, etc.);
4. It is hardly possible to see microorganisms such as chlamydia, urea and mycoplasma under a microscope, just as it is difficult to distinguish pathogenic diplococci that cause gonorrhea from pairwise enterococci or a chain of Enterococcus faecalis (enterococci too) from streptococci, therefore in such cases, to clarify the species The study of the pathogen is supplemented by the cultural method or the almost universal and popular nowadays PCR (polymerase chain reaction);
5. With rare exceptions, E. coli can be detected in a man's smear (a flagrant violation of hygiene rules!), which is beneficial in the intestines, but causes cystitis when it enters the man's urethra. For its differentiation additional laboratory methods research.

The same is done with female smears, since the diplococci found may not be Neisseria and may not cause gonorrhea. By the way, E. coli (Escherichia coli), enterococcus (Enterococcus faecalis), staphylococci with streptococci and other microorganisms in female smears are much more common, which is due to the structure of the female genital organs.

Ecosystem of the female urogenital tract

Leukocytes in a smear taken in gynecology, whether for flora or cytology, are not the only cells present in the preparation. In addition, they act only as a consequence or reaction to events occurring in the ecosystem (hormonal fluctuations, inflammation). For example, their increase in various phases of the cycle is due to hormonal influence, therefore, when collecting material, the date of the last menstruation is indicated on the referral form.

A diagnostic criterion for the inflammatory process is considered not only a large number of Le, “running” to the site of “military actions,” but also the state of their nuclei. When leukocytes react, they try to absorb the “enemy”, phagocytose, but at the same time begin to destroy themselves. The destroyed cells are called neutrophilic leukocytes, but this phenomenon is not indicated in the analysis transcript. A large number of neutrophilic leukocytes, together with abundant cocco-bacillary or coccal flora, serves as the basis for confirming the presence of an inflammatory process.

The ecosystem of the female genital organs includes microorganisms that occupy certain niches, which are: the epithelium of the vagina, cervix, cervical canal, rich in endocervical glands. These anatomical formations provide conditions for the life of certain microorganisms. Some of the inhabitants are obligate, while others come from outside due to certain circumstances and cause various inflammatory reactions of the epithelium.

In addition, the balance in the ecosystem can be disrupted by various factors that negatively affect a woman’s body (both internal and external), which lead to the fact that microbes living in small numbers begin to displace the natural inhabitants, representing the rod flora, and occupy the dominant position. position. An example of this is the colonization of the vaginal environment by Gardnerella, which for a number of reasons displaces lactobacilli (Doderlein bacilli). The result of such a “war” is widely known.

Normal in a gynecological smear

The microscopic creatures that live in the genital tract of a woman are diverse, but norms still exist, although sometimes their boundaries are very difficult to determine, but we will still try to do this. Thus, in a smear taken in gynecology you can find:

• Leukocytes, the norm of which in the urethra is up to 10 cells in the field of view, in the cervix and its canal - up to 30 cells. During pregnancy, these indicators change upward;
• The type of epithelium in the smear depends on the location of the material collection: the urethra, neck, and vagina are lined with stratified squamous epithelium (MSE), which we will obtain in the preparation. A smear from the cervical canal will be represented by cylindrical (prismatic) epithelium. The number of cells changes in different phases of the cycle, but in general, it is generally accepted that, under normal conditions, their content should not exceed 10 units. However, all this is very conditional, since for accurate diagnosis it is necessary to take into account morphological changes in cellular structures(nucleus, cytoplasm, presence of “naked nuclei”), that is, carry out cytological analysis;
• Mucus in the preparation is considered an obligatory, but moderate, component, because the glands of the cervical canal and vagina secrete it. The mucus looks interesting ovulatory phase menstrual cycle, it crystallizes and forms patterns similar to the leaves of the plant, which are called the “fern symptom” (cytology);
• A normal smear is usually represented by rod flora (lactobacillus) and single cocci.

Opportunistic flora is not always the norm

In addition to lactobacilli - the main representatives of the normal microflora of the genital tract, which have the important function of “self-cleaning the vaginal environment”, other opportunistic microorganisms can be found in small quantities in the smear:

All these representatives of microflora can live without bothering anyone, or cause inflammation under certain conditions. By the way, even lactobacilli in excess quantities and in an abundant bacterial flora can provoke an inflammatory process - lactobacillosis, manifested by itching, burning, and discharge. The disease, of course, is not fatal, but very painful.

Pathogenic "guests"

The presence of pathogenic microorganisms, transmitted mainly through sexual contact, almost always leads to trouble. Local inflammation caused by the pathogen can spread to other organs and systems and (often) become chronic if not treated in time.

This phenomenon is especially dangerous during pregnancy, since many pathogens can have very negative impact on the fetus, so a bad smear during pregnancy is a guide to action, and immediate action. What microorganisms can threaten the human reproductive system through sexual transmission? We probably won’t surprise anyone by naming them, but once again it won’t hurt to remind you of the danger posed by microscopic creatures.

gonococcus - the causative agent of gonorrhea

Thus, pathogenic microflora of the genital tract include:

What is the degree of purity?

A smear to determine the degree of vaginal cleanliness is taken like a regular smear for flora, but is assessed somewhat differently. In gynecology, there is IV degree of purity:

I degree– a rather rare phenomenon, the smear is clean, only rod flora, single leukocytes and squamous epithelial cells in optimal quantities;

II degree– single cocci may “slip” among the rods or other non-pathogenic microorganisms may also be mixed in single copies, this degree is the most common among gynecologically healthy women;

table: standards for assessing vaginal cleanliness

III degree– it is characterized by opportunistic flora and yeast-like fungi that tend to actively reproduce. This may indicate the development of an inflammatory response to the presence excess quantity opportunistic microorganisms. This analysis requires additional examination of the woman;

IV degree– signs of an obvious inflammatory process: abundant coccal or cocco-bacillary (mixed) flora, possible presence of Trichomonas, gonococci or other pathogenic microorganisms. In such cases, additional laboratory tests (bacteriological, PCR, etc.) are prescribed to search for the pathogen and further treatment.

A smear on the flora, although it is considered simple methods, but has great potential. The first step in the laboratory diagnosis of diseases of the urogenital tract, sometimes, immediately solves the problem and allows you to immediately begin treatment measures, the quality of which will subsequently be controlled by the smear itself, therefore it is not recommended to avoid such an accessible procedure. It doesn’t require a lot of expenses, and you won’t have to wait long for an answer.

The article describes one of the main methods for diagnosing cancer. The essence of a cytological study is explained, standards for indicators are given, and the interpretation of the analysis results is explained.

Probably in modern world There is no adult who, in one way or another, has not encountered such a concept as oncology. According to statistics from the Ministry of Health, every day this diagnosis takes the lives of about a thousand of our compatriots, while on the entire planet the weekly number of victims of cancer exceeds one hundred and forty thousand people. In connection with such deplorable statistics, scientific medicine considers the research of oncological diseases a priority in order to prevent and treat them. The most common way to identify cancer-related health problems is to examine cells suspected of being affected by the disease.

What is cytological analysis

As the biology teacher explained, cytology is a branch of biology aimed at studying the cells of the human body. Cytology analysis is a method for identifying all kinds of pathologies in the cellular structures of the internal organs of the body. The results obtained using cytological analysis provide information about the health status of the organs, the stage of the course and the nature of possible illness. By analogy, histology analysis provides information about diseases of the body tissues.

Positive features of cytology analysis:

• High percentage of reliability;
• Does not require surgical intervention;
• Simplicity of the procedure for collecting material - the analysis can be taken directly during the scheduled gynecological examination;
• Relatively low cost of research;
• High speed of data processing - the result, as a rule, can be obtained the next day.

The main problem of the cytological research method is the mandatory understanding of the areas affected by the disease. That is, even when symptoms appear, it can be difficult to determine the specific area of ​​tissue from which a sample of cells needs to be examined for abnormalities.

When is a cytology test performed?

From the above it follows that cytological examination is of great importance in the diagnosis of cancer and precancerous diseases. At the same time, this method helps to determine the presence of inflammation of internal organs and promptly identify developing autoimmune diseases and viral infections.

In various medical fields (gynecological, oncological, surgical), cytology analysis is used for the following purposes:

• Preventative. For example, to monitor the condition of the female genital organs, it is recommended to undergo a cytological examination at least once a year.
• Diagnostic. A cytological examination makes it possible to confirm or refute a possible diagnosis, which corresponds to the results of a visual examination or another less detailed examination. Cytology analysis reveals structural abnormalities of cells, causes of deviations and features of the course of diseases of internal organs.
• To monitor the effectiveness of a therapeutic intervention. During treatment of the disease, it is important to monitor the condition of the body in order to timely adjust the direction of therapy or establish the fact of recovery. In oncology, it is very important to regularly undergo cytological examination, since with its help it is possible to identify trends towards relapse in a timely manner.

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What is the object of cytological analysis?

The human body is a multifunctional cellular formation, therefore samples of all tissues and organs are used for cytological analysis. The only necessary condition is that for a successful test, the sample must be obtained from an area of ​​tissue affected by the disease.

In connection with the source of material collection, the following classification of cytological analyzes is distinguished:

• Exfoliative - tests, the object of study of which is secretions obtained from various internal organs.
• Puncture - tests for which a surgical operation is performed - puncture. The puncture can be taken from the thyroid and mammary glands, lymph nodes, skin, and joints.
• Operating - analyzes for which the biomaterial is tissue and organ areas removed from the body during surgery.

How is a cytological examination performed?

The sample for cytology analysis is taken from tissues and organs whose origin is described in the previous paragraph. The resulting biomaterial sample is placed on a glass slide and prepared for microscopic examination by removing moisture from the sample and adding a staining reagent. Such preparation can lead to partial death of the studied cells and, ultimately, to distorted analysis results.

Not so long ago, the method of liquid cytology began to be used in laboratory activities. This method involves directly immersing the resulting sample in a special preservative, which prolongs the lifespan of cells and protects them from external factors.

It is important to know!

The method of processing the sample for the study is the main factor in the reliability of the results. So, according to statistics, the method of drying a biomaterial sample on a glass slide gives the correct result in 35-90 percent of cases. While the liquid method of processing biomaterial increases the reliability of the analysis to 98%. Therefore, when choosing a diagnostic center, you should give preference to a more modern approach to cytological examination.

• Physical indicators (cell structure, dimensions, geometric shape);
• The orientation of cells in the structure of a substance relative to each other;
• Number of cells in the field of view of the microscope;
• The presence or absence of various physiological cell abnormalities.

Interpretation of cytology analysis results. Normal indicators

The result of the analysis is presented to the patient as a table of the content of elements identified in the cell by microbiological research. Interpretation of results is simplified through the use of international Bethesda systems, which assumes the same recording of the obtained indicators, compared with normal ones, for different laboratories.

Index	What does it mean
NILM	No malignant tumors were found. Norm
A.G.C.	Abnormal result. Pathologies found in gland cells
AGC, favor neoplastic	Abnormal result. Pathology in gland cells, similar to neoplasticity
AGUS-NOS	Abnormal result. Pathologies of unknown nature were found in gland cells
AIS	Abnormal result. Adenocarcinoma in the cervical canal
A.S.C.	Abnormal result. Flat epithelial cells found
ASC-US	Abnormal result. Flat epithelial cells of unknown nature were found
ASC-H	Abnormal result. Flat epithelial cells found, possible presence of HSIL
CIN 1- 3	Abnormal result. Neoplasia of various stages was detected in the cervical canal
CIS	Abnormal result. Carcinoma detected
SIL	Abnormal result. Flat intraepithelial cells found
HSIL	Abnormal result. Flat intraepithelial cells were found in high concentrations
LSIL	Abnormal result. Flat intraepithelial cells were found in low concentrations
NOS	The result is characterized as undetermined
VaIN	Abnormal result. Vaginal neoplasia detected
VIN	Abnormal result. Intraepithelial neoplasia was detected in the vagina

A cytogram is a cytological study that determines the condition of the epithelial cells of the cervix. That is, it is a fingerprint smear that is taken in the cervical area to identify inflammation of the cervical canal, ovaries, fallopian tubes, uterus and other parts of the woman’s reproductive system. After a cytology test, you need to take a smear to determine the vaginal flora to determine sensitivity to antibiotics.

Girls after 21 years of age must undergo a cytology smear every three years for preventive purposes. Regular examinations can only be stopped after age 70, if all test results have been negative within the last 10 years. An unscheduled examination is carried out in the following cases:

How to take material for a cytogram

To obtain scrapings, use special Cervix-Brash brushes or an Eyre spatula. The material is collected using light pressure from the instrument to capture cells from the deep layers of the cervix.

The reliability of the results depends on:

• qualifications of the gynecologist and his ability to correctly take material for analysis;
• experience and attentiveness of the laboratory technician who will analyze the smear and make a conclusion.

If scraping from the cervical canal was performed incorrectly, then after the procedure the patient will experience bloody issues and painful sensations.

For more accurate results, modern gynecology uses new technologies. Its essence lies in mixing the material with a special solution, due to which the epithelial cells are mechanically separated from foreign impurities (blood, mucus, pathological secretions).

During the study, epithelial cells taken from the cervix are highly clear and the number of false negative tests is significantly reduced.

Depending on the number of atypical cells in the smear, 5 classes of cervical condition are distinguished:

1. class - epithelial cells have a normal structure, cytogram without pathology;
2. class - diagnostics detect fungi, chlamydia, viruses in a smear;
3. class - among normal epithelial cells in the field of view of the microscope there are single atypical cells, this condition is called;
4. class - a single smear is detected, suspicion of oncology is diagnosed and the patient is prescribed additional;
5. class - indicates a high probability of cervical cancer; cancer cells are found in large numbers in the smear.

To obtain an accurate result, before taking the test, you must abstain from sexual intercourse, use of a tampon, vaginal suppositories and douching for three days.

A cytogram of cervical inflammation allows you to determine the type of causative agent of the infectious process in the woman’s genital tract and prescribe adequate therapy. In case of inflammation, not only microscopic examination smear, but also culture on nutrient media. This allows you to accurately determine what caused the pathology and how to solve the problem quickly and effectively.

In the case when the cytogram showed inflammation, it is no longer informative in relation to oncology. Therefore, after anti-inflammatory therapy, it is necessary to take a repeat cytology test.

Cytogram during pregnancy

When carrying a baby, a woman experiences changes not only in hormonal background, but also directly in the vaginal microflora. As a result, the body's resistance (resistance to diseases) decreases and the development of fungal infections and inflammatory processes is noted.

Attention! A cytological examination of a smear during pregnancy allows you to determine the state of the microflora, the presence of atypical cells, pathogens, as well as assess the general condition of the mucous membrane of the genital tract and, in the presence of inflammation, determine the degree of its development.

During pregnancy, a smear for flora and cytology is taken three times (if no abnormalities are detected):

1. At the time of registration of a pregnant woman at the antenatal clinic.
2. At 30 weeks during the registration of a pregnant woman’s exchange card.
3. At 36-37 weeks to assess the woman’s body for the upcoming birth of a child and monitor the condition of the birth canal.

The vaginal condition assessment is analyzed as follows:

• 1st degree – vaginal pH is acidic, lactobacilli predominate in the smear, there is no inflammatory process;
• 2 and 3 degrees - the pH of the vagina changes to the alkaline side, minor changes in the cellular composition are noted, the woman is diagnosed with a mild inflammatory process;
• Stage 4 – vaginal pH is alkaline, the amount of lactobacilli is reduced, pathogenic microorganisms are found in large quantities in the smear and an inflammatory process is diagnosed.

If during the study a diagnosis of vaginosis or is established, then the pregnant woman is prescribed a course of treatment, after which the smear must be taken again. In the case when high level leukocytes and pathogenic microbes are present in the smear on last weeks pregnancy, the woman in labor is sent to hospitalization in a special department for pregnant women with pathologies.

On recent months During pregnancy, the number of intermediate, parabasal and superficial cells in the cervical canal increases. They are detected in a smear for flora and cytology. The greater the number of such cells, the closer the onset of labor.

How to eliminate cervical inflammation

If vaginal candidiasis (thrush) is detected in a woman, treatment is carried out with local antifungal drugs. In this case, the doctor prescribes exactly the remedy that will negatively affect the vital activity of pathogenic microorganisms.

Video: cervical smear

Video: necessary and unnecessary tests in gynecology

Cytological examination in gynecology is an important diagnostic method that allows us to establish a number of deviations from the norm, which include the inflammatory process. A cytogram is the result of an analysis of a smear obtained from the cervix. In addition to inflammation, it allows you to detect cancer, since the smear may contain cells with signs of atypia.

In the case of pathologies of the cervix of an inflammatory nature, the following formulation will be given in the conclusion of the cytological examination: “Cytogram of inflammation with reactive or degenerative changes epithelium". This means that the analysis corresponds to type 2 Papanicolaou smear, and the biomaterial contains inflammatory elements.

After receiving laboratory test results that indicate inflammation, the doctor must prescribe appropriate treatment for the patient. After a course of therapy, a smear is taken again to confirm the effectiveness of the measures taken and cure.

An inflammatory cytological picture may appear for the following reasons:

• Diseases of an infectious nature, including trichomoniasis, chlamydia, actinomycosis, candidiasis, genital herpes, etc.
• infection caused by the human papillomavirus.
• Atrophic inflammation.
• The period of bearing a child.
• Medicinal effects.
• Undergoing radiation therapy.
• Using an intrauterine device as a means of contraception.

Please note that the inflammatory type of smear can also be recorded in the case of mild degree dysplasia. In this situation, medical supervision and periodic repetition of cytological analysis are required.

Analysis

An inflammation cytogram is the result of a cytological examination of a cervical smear, which allows one to identify a disease such as cervicitis. Treatment tactics for this disease may differ depending on the etiological factor, so the patient is prescribed not only a cytology smear, but also a number of additional diagnostic procedures.

In order for a cytology smear to help identify the inflammatory process, you need to prepare for the procedure. For this purpose, a woman is recommended:

• Avoid sexual intercourse for 3 days before the procedure.
• Do not use vaginal suppositories, creams, gels.
• Do not douche before testing.
• Do not urinate for 2-3 hours before taking the test.

Typically, a smear for cytology is taken on days 5-10 of the cycle, that is, after the end of menstrual bleeding.

The test itself is a procedure in which the doctor takes scrapings from the vagina and cervical canal. The manipulation is carried out on a gynecological chair and takes only a few seconds. After the biological material is removed, it is sent for analysis to a laboratory.

Interpretation

Some terms found in laboratory reports are presented below:

• Koilocytes. Squamous epithelial cells whose nuclear structure is changed. Occurs in case of human papillomavirus infection.
• Leukocytes. The detection of these cells in significant numbers indicates the presence of inflammation.
• Neutrophils. A type of leukocyte cell present in a smear in the event of activation of a pathological process of inflammatory origin.
• Exocervix. The mucous lining of the vaginal portion of the cervix.
• Endocervix. Mucous lining of the cervical canal.
• Hyperkeratosis. The phenomenon of keratinization of the cervical epithelium. If hyperkeratosis is detected, a colposcopy is additionally performed, and material is taken for study using a targeted biopsy. In case of active inflammation, all these manipulations are carried out after the course of treatment.


• Red blood cells. Blood cells. They are found in a smear in case of damage to the mucous membrane during the collection of biomaterial.
• Ectopia (pseudo-erosion). The location of the columnar epithelium, which normally lines the cervical canal, in the vaginal portion of the cervix.
• Atypia. Changes in cell structure. Atypical cells can be detected both in active inflammation and in oncological pathologies.
• Endocervicitis. Inflammation of the mucous lining of the cervical canal.
• Estrogen type of smear. The type of smear that is normally characteristic of patients of childbearing age.
• Atrophic type of smear. Type of smear with insufficient estrogen concentration. More often detected during the menopausal period.

In any case, the analysis must be deciphered by a doctor. Even if the analysis shows a cytogram of inflammation, examination and further examination are still necessary.

A cytogram of inflammation - what it means and how to treat it interests patients. This analysis result most often indicates the development of an inflammatory disease of the cervical canal. If this diagnosis is confirmed, the woman will be prescribed complex anti-inflammatory therapy:

• taking antibiotics, antifungal drugs;
• taking non-steroidal anti-inflammatory drugs;
• use of vaginal suppositories.

Drugs are prescribed on an individual basis, it all depends on what pathogen provoked the occurrence of cervicitis.

A cytogram of severe inflammation is not a terrible diagnosis, but a reason to see a gynecologist again and be examined. Timely diagnosis and treatment of inflammatory diseases will help avoid many complications, including infertility, tumor formation, and hormonal imbalances.

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What is a cytology smear?

A cytological smear (Papanicolaou test, PAP test) is a laboratory microscopic examination of the upper ball of the cervix, intended for the timely diagnosis of cancer. This method is the most painless, simple and fast among all known examination methods.

Purpose of the analysis

In order to prevent and prevent the development of dangerous diseases, cytology of a smear from the cervical canal is done for every woman. This analysis allows us to identify abnormalities in the cellular structure of the cervix that cause the development of cancer. To avoid possible pathologies, all women should regularly visit a gynecologist. If changes occur, they are recorded on early stage when the disease is treatable and full recovery is still possible.

In addition to cellular pathologies, a cytology smear allows you to evaluate the mucous membrane and determine the presence of harmful microorganisms in the vagina. The PAP test does not determine the exact data of these parameters, so in such cases it is necessary to use additional methods of analysis.

Indications for Pap test

A smear for cervical cytology is prescribed to all women over 18 years of age during a routine examination by a gynecologist once a year. Also, indications for the analysis include: menstruation disorders, the presence of papilloma virus and genital herpes, free sexual intercourse, infertility, the use of hormonal contraceptives, the installation of an intrauterine device, planning pregnancy. Infectious diseases are also often a reason to take a smear for cytology. What the result shows can only be determined by a specialist.

Risk group

Regardless of age, there are certain factors whose exposure increases the risk of developing cancer. With prolonged action on female body they weaken immune system. This risk group includes women who have many sexual partners, smoke, have weak immunity, are carriers of viruses, and began sexual activity in early age, have had cancer of the reproductive system in the past.

How to make a smear

To obtain reliable results, a woman must stop taking antibiotics a week before the test. The day before the study, you need to stop douching and placing vaginal suppositories and having sexual intercourse.

A smear is taken on the chair during an examination by a gynecologist. The doctor takes 3 smears: from the walls of the vagina, from the cervical canal (cervical canal) and from the mouth of the paraurethral passages. This procedure is completely painless. A speculum and spatula are used to take a smear. To prevent objects from being cold and creating unpleasant sensations, they can be heated with hot water before use.

At the next stage, the doctor applies the test material to a special glass, on which it will be examined under a microscope. laboratory analysis smear for cytology.

Interpretation of research results

The last and most important stage of the study is deciphering the smear for cytology. According to the analysis, the doctor can obtain information about the condition of the epithelium, the presence of inflammation and the composition of the microflora. In modern medical practice, the Papanicolaou technique is widely used to decipher the results of a smear, according to which there are 5 stages of the development of pathologies.

Stage 1 - there are no abnormalities, cytology is normal. This stage indicates the woman’s health.

Stage 2 - during a routine examination or based on complaints, a woman takes a smear for cytology, which shows a slight change in the structure of the cells. It is caused by inflammation of the internal genital organs. This stage is also considered normal, but still requires more thorough research to determine the causes of the disease.

Stage 3 - a small number of cells with abnormalities in the structure of the nuclei were detected. In this case, you need to take repeat smear and conduct a histological examination of the tissue.

Stage 4 - during the analysis, cells with malignant changes can be identified. For example, increased nuclear mass, changes in the cytoplasm and chromosomes. The result obtained is not a final diagnosis, but serves as a reason for further examination.

Stage 5 - cancer cells are present in large numbers in the smears.

Deciphering a smear for cytology may take some time. Usually it takes a few days, but there are times when you need to wait a week for results.

The reliability of the results of the Papanicolaou method is very high, especially when a smear is examined for cervical cytology. But about the condition of the uterus itself, ovaries and fallopian tubes this analysis does not provide any information. There are times when a PAP test gives false data. Therefore, to accurately interpret the results, it is necessary to undergo a comprehensive examination.

Positive results: types of pathologies

If the research data obtained corresponds to the norms, then no abnormalities were identified and the woman is healthy. In case of positive results, pathology develops.

Finding abnormal cells does not always indicate the presence of cancer. Dangerous infectious diseases are often detected during a Pap test.

1. Human papillomavirus infection - the formation of genital warts in the vagina and on the cervix. This virus is very dangerous for women's health.

2. Chlamydia is the most common sexually transmitted infection. Basically, this disease occurs without pronounced symptoms. In addition, it is difficult to diagnose in the laboratory. This makes treatment difficult, and its absence can lead to serious complications.

3. Trichomoniasis is a popular sexually transmitted disease. The main symptoms of the disease: itching, yellow-green discharge, discomfort when urinating and during sexual intercourse. Timely diagnosis of pathology allows you to completely cure the disease.

4. Gonorrhea is an infectious disease genitourinary system. The chronic form of the disease is often the cause of infertility in women.

5. A yeast infection is an overgrowth of fungus that lives in the vagina. For some reason, its reproduction gets out of control and inflammation occurs. It is accompanied by irritation and itching, white discharge with a characteristic odor.

If the smear test is positive due to the presence of infection, the identified diseases should be treated. Very often it is difficult to determine cancer precisely because of viruses. Therefore, after a course of therapy, it is necessary to repeat the analysis to obtain more accurate data.

Depending on the pathology, sometimes it is necessary to take a second smear for cytology, which shows the dynamics of changes in the structure of cells over a certain period.

Taking a smear during pregnancy

At the slightest suspicion of the presence of infections and fungi harmful to the fetus, cytology is often used. The inflammatory type of smear makes it possible to diagnose pathological processes if a woman complains of burning and itching of the external genitalia, changes in the color and smell of discharge. To analyze the state of the vaginal microflora in pregnant women, cytology smears are done at least three times. If necessary, your doctor may order additional Pap tests.

A Pap test for pregnant women is performed using conventional technology.

Possible complications after taking a smear

Taking a smear for cytology should be done by a specialist doctor who knows the technique of this process. There may be some complications after performing a Pap test. Most often they manifest themselves as severe pain after manipulation and bleeding for a day or a little longer. Such symptoms are considered completely normal and do not require treatment. If you experience severe abdominal pain after the examination, elevated temperature and chills, you need to see a doctor.

Cytology of a smear from the cervical canal when taken incorrectly also sometimes has dangerous consequences. With rough intervention, stenosis caused by adhesions may develop. For this reason, it is not customary to carry out prophylactic smear taking in deep places of the cervical canal.

For a week after the PAP test, you should avoid intimate relations, douching, and the use of tampons.

A cytological smear is considered the best method for detecting cervical cancer in the early stages of development. But even the best laboratories sometimes cannot detect cellular changes. Therefore, for a greater likelihood of detecting pathology, you need to take a smear annually.

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CYTOLOGY smear is a method of microscopic examination of the cervical epithelium for the purpose of PREVENTION AND EARLY DIAGNOSIS OF CERVICAL CANCER.

• What does a cytology smear show? general information
• Liquid and classical cytology, how long does it take to test?
• Atrophic type of smear
• Terms found in the cytogram
• Cytogram interpretation (NILM, ASCUS, LSIL, HSIL)
• Online consultation in the comments

Cytology smear Firstly carried out to detect atypical cells, which allows early diagnosis of dysplasia (CIN, LSIL, HSIL) or cervical cancer. It is an inexpensive and convenient method for reaching large numbers of women with preventative care. Of course, the sensitivity of a single study is low, but annual mass screening in developed countries has significantly reduced the mortality rate of women from cervical cancer.

Due to the fact that atypical cells can be located in a relatively small area of ​​the mucosa, it is very important that the material is obtained from the entire surface of the cervix, especially from the cervical canal! For this purpose, special brushes have been created that make it possible to obtain material from areas inaccessible to inspection.

Particular attention is paid to the transformation zone, the cells of which most often undergo tumor degeneration. It is in the transformation zone that up to 80-90% of cervical cancer develops, the remaining 10-20% occur in the cervical canal.

When to take a smear for cytology? A smear for cytology should be taken starting from the 5th day of the menstrual cycle and 5 days before the expected start of menstruation. The analysis cannot be carried out within two days after sexual intercourse or insertion of suppositories into the vagina. Failure to follow these rules may lead to erroneous interpretation of the results. Also, the presence of a pronounced inflammatory process in the cervix and vagina seriously complicates diagnosis.

It should be noted that collecting material is a rather unpleasant procedure. The gynecologist must scrape the epithelium from the surface of the cervix and enter the cervical canal. The more epithelium from different zones gets in, the better the diagnosis. Sometimes bruising may remain after cytology, this is considered normal.

Thus, the main significance of a cytology smear is to determine qualitative changes cells. To determine the infectious agent that caused inflammation, it is better to use flora smear or bacteriological culture. However, during a cytological examination, the doctor may note the presence of any microorganisms. Normal microflora includes rods (lactobacillus), single cocci, and in small quantities there may be opportunistic flora. The presence of specific infectious agents (Trichomonas, amoebas, fungi, gonococci, gardnerella, leptothrix, chlamydia, an abundance of cocci) is considered a pathology that needs to be treated.

Processing of smears. Cytology deadlines

After collecting the material, the sample is transferred to a glass slide, fixed and stained. When directly transferring a smear from a brush, partial loss of material and cell deformation are possible, which leads to a decrease in the sensitivity of the method and a large number of false results. The classical method was replaced by liquid cytology, which significantly increased the accuracy and quality of the study.

Liquid cytology is a new technology for processing smears, which involves placing samples in a container with a special stabilizing solution. In this case, the entire resulting epithelium enters the solution, which is then centrifuged and cleared of unwanted impurities (mucus, etc.). Today, liquid-based cytology is becoming the “gold standard” for examining smears from the cervical mucosa. But even in this case, the sensitivity of a single study does not exceed 60-70%. During reproductive age, false negative results are common, and in menopausal women, false positive results are common. Only triple cytological examination allows one to approach 100%.

There are various methods for staining preparations: according to Papanicolau (Pap test), according to Romanovsky, according to Wright-Diemsa, according to Gram. All methods are aimed at staining certain cellular structures, which allows differentiation Various types epithelium, distinguish cells with keratinization and tumor transformation. The Pap test is widely accepted and is now used as the main standardized test.

How long does the test take? Depending on the organization of the process, the result can be obtained within 2-3 days.

Cytogram without features - what does this mean?

Cytological findings vary widely. As a variant of the norm, the following conclusions can be used: “ cytogram without features «, « cytogram within normal limits «, « cytogram without intraepithelial lesions «, « cytogram corresponds to age - atrophic type of smear «, « NILM— Negative for intraepithelial lesion or malignancy«, « proliferative type of smear ". All this is NORMAL!

The cervical mucosa is normally smooth, shiny, and moist. The squamous epithelium is pale pink, the glandular epithelium is bright red. The cellular composition that can be found in normal cytology is presented in the table.

in women of reproductive age
Exocervix	Well-preserved cells of squamous epithelium, mainly of the superficial, intermediate layers.
Endocervix	Cells of glandular (cylindrical) epithelium.
Transformation zone	Squamous epithelial cells, single cells or small clusters of metaplastic squamous epithelium, small clusters of glandular epithelium.

Atrophic type of smear - what does it mean?

In women in perimenopause and menopause, due to a decrease in the overall level of estrogen, many metabolic processes slow down, which results in atrophy of the squamous epithelium. These changes can be seen in the cytogram. The atrophic type of smear refers to a variant of the normal cytogram. You can often find the phrase “ cytogram corresponds to age " or " age-related changes nilm ". All these are variants of the norm!

You need to understand that in menopausal women, false-positive cytogram results are very common - this is the case when it is difficult for a cytologist to distinguish atrophic squamous epithelium from dysplasia. This needs to be understood because subsequent cervical biopsies usually do not find any pathology. In addition, older women may have a tendency to keratinize the epithelium with the formation of hyperkeratosis (leukoplakia).

Cytogram without features (NILM) in women in peri- and menopause ( atrophic type of smear)
Exocervix	Well-preserved squamous epithelial cells, mainly of the parabasal and basal layers. More often there are smears of the atrophic type, but they can also be of proliferative or mixed types.
Endocervix	The absence of columnar (glandular) epithelial cells is not an indicator of poor quality of the smear, since during this period the transformation zone moves deep into the canal and to obtain glandular epithelium the brush must be inserted to a depth of more than 2-2.5 cm.
Transformation zone	Cells of squamous, metaplastic epithelium.

The mucous membrane of the cervix in menopause is thinned, easily injured and damaged, which is a consequence of a decrease in estrogen.

Decoding the cytogram

Terminology

Dyskaryosis and discaryocytes- abnormal cells with hyperchromatic (dense and dark) nuclei and irregular nuclear chromatin. Dyskaryosis will be followed by the development malignant neoplasm. Used as a synonym for dysplasia, but as a more general term.

Atypia- any difference in cell structure from the norm. The meaning often depends on the context. But more often it is used to describe pre-tumor and tumor changes.

Inflammatory atypia- a combination of degenerative, reactive, proliferative changes in cells during inflammation. These changes can cause a false-positive diagnosis of dysplasia or cancer.

Dysplasia- the process of disrupting the maturation of squamous epithelium. It is a true pre-tumor process. Has 3 degrees. The first usually includes a viral lesion, the second and third - a lesion with tumor potential.

ASCUS- atypical cells that are difficult to differentiate from reactive atypia and the pretumor process itself. Atypia of unknown significance.

Dyskeratosis- violation of keratinization of individual squamous epithelial cells. Is a sign of HPV.

Parakeratosis- violation of keratinization of the epithelial layer. Surface squamous epithelial cells always have some degree of keratinization - this is a protective mechanism. Parakeratosis can be observed normally, with irritation of the mucous membrane for any reason, or with HPV infection.

Koilocytosis (koilocytic atypia, koilocyte)- specific nuclear changes characteristic of human papillomavirus.

Hyperkeratosis (leukoplakia)- pronounced keratinization of the epithelial layer with the appearance of a protective structureless layer of keratohyalin. This is a normal process for the skin, but in the mucous membranes it is considered a pathology. It is observed with HPV infection, as well as with irritation of the mucous membrane, especially with prolapse of the pelvic organs and uterine prolapse.

Squamous metaplasia- a protective mechanism, the physiological process of replacing delicate glandular epithelium with more stable squamous epithelium. Metaplastic epithelium often becomes a source of dysplasia and cancer, as it is easily affected by the human papillomavirus.

Glandular hyperplasia- proliferation, active growth of glandular epithelium. It is a reactive process during inflammation and erosion of the cervix. Often occurs when using hormonal drugs.

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What is this?

An inflammatory cytogram is a set of changes in a smear, indicating the presence of an inflammatory process in the cervix.

A study during which such changes can be detected is called a cytological test (Pap test). In the process of cytological examination, a thorough study of the cellular composition of the resulting preparation is carried out. The number of leukocytes, eosinophils and other formed blood cells is determined, the shape of epithelial cells, the location of chromatin in the nucleus, the relative position of epithelial cells, reactive changes in the obtained material, the presence of microorganisms in the cells that may be the cause of the identified inflammation are studied. These indicators are determined in all layers of the epithelial layer.

The data obtained are used to calculate a number of important indicators that facilitate the interpretation of the analysis: karyopyknotic index, eosinophilicity index, maturation index.

Speaking in simple language, a cytogram of inflammation is a leukocyte infiltration of the cervical epithelium, detected during a cytological examination.

The resulting cytogram of inflammation requires a smear to study the microflora and determine its sensitivity to antibacterial drugs.

After completing the course of treatment, repeated treatment is required. this study to confirm cure.

What diseases can cytology show?

With the help of cytological examination it is possible to determine:

1. The course of the inflammatory process in the cervix.
2. Assume infection of the body with human papillomavirus types 16 and 18, which are provocateurs for the development of cervical cancer.
3. The presence of atypical (cancerous) cells in the cervix.
4. The development of cervical diseases such as erosion and leukoplakia.

How to prepare

To obtain a cytogram that reflects the real state of the cervical cells and minimize the risk of an erroneous conclusion, you should adhere to small restrictions before taking a smear for cytological examination.

Avoid sexual intercourse 2 days before taking a smear.

A woman should not douche or inject any medicines in the vagina.
You should also stop taking hormonal medications if a cytological examination is planned. A gynecologist can tell you in detail how and when it is best to do this.

You should not come for a cytological examination immediately after the end of menstrual bleeding or on the eve of the arrival of your period. The most favorable time for taking a smear for a cytogram is considered to be the middle of the menstrual cycle, starting from the 13th day after the end of menstruation.
Any inflammatory diseases vagina and cervix should be treated. If a woman has similar diseases, then when taking a smear there is a risk of the inflammatory process spreading into the deeper layers of the inflamed tissue, as well as the risk of purulent inflammation. For these reasons, a smear for cytology is taken only in the absence of manifestations of active inflammation.

In pregnant women, taking a smear for cytological examination is not possible. The fact is that in pregnant women, the cervical canal of the cervix is ​​clogged with a mucus plug, and when taking a smear from the cervical canal, the mucus plug may be damaged. Moreover, the reaction of the uterus after such an intervention can be unpredictable. That is why you should take care of the pregnant uterus and wait until delivery. After childbirth, it is permissible to take a smear for a cytogram only after complete restoration of the birth canal and uterine tone.

How is the material obtained?

For women who are regularly examined by a gynecologist, this procedure will not be fundamentally new. The only difference is that the smear is taken with a special brush, and not with a Volkmann spoon, as during the usual smear procedure.

The brush is inserted into the cervical canal and scrolled several times clockwise and counterclockwise. After this, the taken material is applied to a glass slide and fixed with a special solution to keep the cells from drying out.

Then, the resulting preparation is placed under a microscope for a detailed study of the cellular composition.

What could be the conclusion?

One of the most common options for the conclusion of a cytological study is an inflammation cytogram. It should be said that a cytogram of inflammation is one of the least dangerous conclusions that can be issued during cytology.

In addition to inflammatory changes, the cytogram may contain information about the presence of koilocytes. Koilocytes are cells that appear when a woman is infected with the human papillomavirus. If such cells are detected, the woman must undergo additional tests to confirm the presence of this virus in the body.

The cytogram may reflect the development of leukoplakia (hyperkeratosis) of the cervix. You can suspect its presence even during a smear, since it is visible to the naked eye. Leukoplakia looks like areas of keratosis white on a pink background of healthy cervical mucosa.

Atypical cells may also be detected during cytological examination. These are cells that divide quickly and randomly and have irregular shapes and sizes. If such cells are detected, the tissue is taken again for analysis to eliminate a possible error. The appearance of such cells in the cytogram indicates a precancerous condition of the cervix and requires immediate initiation of treatment measures.

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A cytology smear (synonyms: cytology, atypia smear, oncocytology smear, Pap test) is an examination method in gynecology that allows you to detect most precancerous or cancerous changes in the cervix at an early stage, when they are asymptomatic.

Why do you need a smear for cytology?

Pap smears have helped save the lives of millions of women by helping to detect precancer or cervical cancer while it is still curable.

Who needs a smear for cytology?

Every woman over 25 years of age must undergo a cytology smear. It does not matter whether you are sexually active: a smear must be taken in any case.

How often should I have a smear for cytology?

Starting from the age of 25 years, cytology must be taken every 2 years. If the next smear for atypia reveals any undesirable changes, then subsequent examinations will need to be carried out more often: 1-2 times a year (depending on the changes detected).

On what day of the cycle should you take a smear for cytology?

It is recommended to take a Pap test no earlier than the 5th day of the menstrual cycle (the first day of the cycle is considered the first day of menstruation), and only if menstruation has already ended. At the latest, a smear can be taken 5 days before the start of your next menstruation.

How to prepare for a smear test for cytology?

To obtain adequate examination results, gynecologists recommend abstaining from sexual intercourse 1-2 days before taking a smear. In addition, try not to douche, use tampons, or insert any medications (vaginal tablets, suppositories) into the vagina at least 2 days before visiting a gynecologist.

How is a smear taken for cytology?

A smear is taken from the cervix in the gynecologist's office, on a gynecological chair (as during a regular gynecological examination).

In order to see the cervix, the doctor will insert a speculum into the vagina. Insertion of the speculum may cause discomfort, but is usually not painful.

After this, the gynecologist will take a special sterile brush, with which he will scrape off part of the upper layer of the cervix and the cervical canal. The resulting material will then be applied to a glass slide and sent to the laboratory to be examined under a microscope.

Liquid cytology

In the last few years, another method of preparing a smear for atypia has become widespread - liquid-based cytology. Currently, this technique is considered more informative than a regular smear, since liquid cytology is less likely to give false negative results, and therefore more effectively identifies atypical cells in the cervix.

Unlike the standard preparation of a smear for cytology, the resulting material from the cervix is ​​not immediately applied to a glass slide, but is first mixed with a special solution. Thanks to this, all obtained cervical cells are included in the study, and at the same time, mucus and white blood cells, which can complicate diagnosis, are eliminated.

Cytology smear: does it hurt?

Taking a smear itself does not cause pain or discomfort. The most unpleasant stage of this entire process is the insertion of a speculum. However, an experienced gynecologist inserts the speculum quickly and carefully, so the discomfort will not last more than 5-10 seconds.

When can I find out the results of a smear for cytology?

Cytology results are usually provided in 1-2 weeks. Ask your doctor when you will receive your test results.

Interpretation of the results of a smear for cytology (cytogram)

Cytology smear results may vary depending on the country in which you live and the laboratory in which the smear was examined.

Only your gynecologist can adequately interpret the results of cytology. Do not rush to interpret the smear results yourself, as some data may unduly frighten you.

In this article, we'll look at the meaning of key terms you may see in your smear results.

What is the quality of the drug?

The quality of the drug means how correctly (quality) the gynecologist took the smear. Adequate quality of the drug means that the smear was taken correctly and the smear results will be reliable.

Inadequate quality of the drug means that the smear was taken incorrectly and its results will not be informative. In this case, it is recommended to retake the smear.

What is exocervix and endocervix?

Almost any cytology smear result includes data from two points (loci): from the exocervix and from the endocervix.

The exocervix is ​​the outer part of the cervix that comes into contact with the vagina (the vaginal part of the cervix). Normally, the exocervix contains cells of stratified squamous epithelium (MSE) of the superficial, intermediate and parabasal layers. In some women, columnar epithelium is also found in the endocervix.

The endocervix is ​​the canal of the cervix. Normally, columnar (glandular) epithelial cells are found in the cervical canal, but stratified squamous epithelial cells can also be found.

What is CBO?

CBO is an abbreviation that stands for “cytogram without features.” That is, this is the norm.

What is NILM?

The abbreviation NILM means the same thing as CBO, that is, a cytogram without features. No malignant cells were found, the smear was within normal limits.

What is proliferation?

Proliferation is the accelerated division of cervical cells, which usually indicates an inflammatory process. Proliferation can be moderate with minor inflammation, or pronounced with severe inflammation.

What is leukocyte infiltration?

Leukocyte infiltration is an increased number of white blood cells in the cervix, which indicates inflammation. Leukocyte infiltration in the vaginal part of the cervix may indicate exocervicitis and vaginitis (inflammation of the vagina).

Leukocyte infiltration in the cervical canal indicates endocervicitis (inflammation of the cervical canal).

What is an inflammation cytogram?

An inflammatory cytogram is a set of changes found in a smear that indicate that an inflammatory process is occurring in the cervix (cervicitis).

If you have been diagnosed with a cytogram of inflammation, you need to undergo a course of treatment and repeat the cytology smear after recovery.

What are koilocytes?

Koilocytes are the cells that are found in a cytology smear if a woman is infected with the human papillomavirus (HPV).

Normally, healthy women should not have koilocytes. If you have been diagnosed with koilocytes, you need to be tested for HPV and undergo a colposcopy.

What is hyperkeratosis?

With hyperkeratosis, abnormal cells are found in the smear that are not cancerous, but may indicate unwanted changes in the cervix.

If hyperkeratosis (leukoplakia) was detected in your smear, then you need to be tested for HPV and undergo colposcopy.

What is metaplasia?

Metaplasia is the process of replacing cells of one type with cells of another type. Since the mucous membrane of the cervix is ​​represented by two different types cells, then the process of metaplasia in the cervix is ​​a completely normal phenomenon. Squamous metaplasia can be detected in a normal cytology smear.

What is dysplasia?

Dysplasia is a precancerous condition of the cervix that can develop into cancer within a few years. There are 3 degrees of cervical dysplasia (mild, moderate and severe dysplasia). Read about what this means and how it is treated in the article Cervical Dysplasia.

What is ASC-US?

ASC-US (atypical squamous cells of undetermined significance) is an English abbreviation that means that atypical squamous epithelial cells were detected in the smear, the cause of which is unknown.

The cause of the appearance of such atypical cells is most often inflammation of the cervix, but the risk of more serious changes cannot be ruled out.

If ASC-US is detected, your doctor may recommend a repeat Pap test in 6 months, or may immediately recommend additional testing: a high-risk HPV test, colposcopy, and, if necessary, a cervical biopsy.

If you are over 45-50 years old and have been diagnosed with ASC-US, then your doctor may recommend estrogen cream, since it is the lack of estrogen in the blood that can cause the appearance of atypical cells at your age.

What is ASC-H?

ASC-H (atypical squamous cells, cannot exclude HSIL) means that some squamous cells appear abnormal (atypical) and are similar to precancerous or cancerous changes in the cervix. To clarify the diagnosis, your gynecologist will prescribe a colposcopy and, if necessary, a cervical biopsy.

If the colposcopy is normal, your doctor will recommend repeat smear cytology in 6-12 months.

What is AGC?

AGC (atypical glandular cells) means that abnormal (atypical) columnar epithelial cells were found in the cytology smear. To clarify the diagnosis, your gynecologist will prescribe a colposcopy and, if necessary, a cervical biopsy and endocervical curettage.

What is LSIL?

LSIL (low-grade squamous intraepithelial lesion) means that atypical cells were found in the smear, which most likely are not related to cancer, but require a more thorough diagnosis. To clarify the diagnosis, your gynecologist will prescribe a colposcopy and, if necessary, a cervical biopsy.

If the colposcopy is normal, your doctor will recommend repeating the smear for atypia in 6-12 months.

What is HSIL?

HSIL (high-grade squamous intraepithelial lesion) means that you have been diagnosed with precancerous changes in the cervix. The squamous epithelium has undergone precancerous changes. Without treatment, this condition can progress to cervical cancer.

What is AIS?

AIS (adenocarcinoma in situ) means that you have been diagnosed with precancerous changes in the cervix. The columnar epithelium underwent precancerous changes. Without treatment, this condition can progress to cervical cancer.

What to do if a cytology smear shows abnormalities?

If the cytology results indicate possible inflammation or other processes in the cervix, ask your gynecologist to comment on the results and explain what this means.

Depending on the type of changes detected, the gynecologist may advise you to take a second smear in a few months, or prescribe additional examinations in order to clarify your diagnosis.

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How to treat an inflamed cervix

If this vaginal candidiasis (thrush), then local treatment with antifungal drugs, for example, Clotrimazole, will be required. Medicines with active ingredients: isoconazole, miconazole, natamycin, nystatin.

If this bacterial vaginosis, key cells and coccal flora were found in smears from the cervical canal, then they will prescribe antiseptics like Hexicon (chlorhexidine), metronidazole or a complex drug - Terzhinan.

If found urogenital trichomoniasis drugs of the nitroimidazoles group are prescribed: Metronidazole, Ternidazole, Neomycin, Nystatin.

At chlamydial cervicitis take tetracycline, doxycycline and or erythromycin orally.

At actinomycosis caused by wearing an intrauterine device (IUD), you must first remove the intrauterine contraceptive. And then, there are options. These may be penicillin antibiotics:

• tetracyclines;
• cephalosporins (cefaclor, cephalexin);
• aminoglycosides (amikacin, gentamicin, tobramycin).

Broad-spectrum antibacterial drugs:

• metronidazole (metrogyl, trichopolum, efloran);
• clindamycin (dalacin, climycin, clindamycin).

The following medications help greatly:

• co-trimoxazole;
• sulfadimethoxine;
• sulphacarbamide.

In case of exacerbation genital herpes, doctors recommend local therapy with drugs:

• "Acyclovir";
• Famciclovir;
• Valaciclovir.

If relapses of the disease are frequent, the same medications are prescribed in the form of tablets for oral administration.

Unfortunately, there is no cure for HPV. But within 1-2 years after the manifestation of the disease, the immune system overcomes the virus, and it ceases to negatively affect the cervix. The main thing is to hold out for these few months.

At atrophic colpitis(atrophic type of smear, ATM) treatment is carried out with antibacterial agents, usually of complex action, and then the woman is prescribed hormone replacement therapy (HRT) if necessary and if there are no contraindications for it.

Causes of inflammatory type of smear (ITM)

1. Infections and fungal diseases:
   • trichomoniasis;
   • candidiasis;
   • chlamydia;
   • actinomycosis;
   • genital herpes;
2. Atrophic vaginitis.
3. Radiation therapy (radiation damage).
4. Pregnancy.
5. Impact of certain medications.
6. Intrauterine device (IUD).

Could the cause of the deviations be not an infectious process, but precancer or cancer? As we said earlier, with this type of conclusion, doctors call the cells “indeterminate.” It is not yet entirely clear whether this will go away on its own after treatment or whether it is still precancer and it is necessary to remove the pathological areas of the cervix.

A smear from the cervix of the uterus of the inflammatory type (ITM) also occurs with mild dysplasia (CIN 1). It is observed (the woman undergoes a smear for oncocytology once every 6 months) or is advised to remove it after a biopsy - with nitrogen, radio waves, electric shock or otherwise.
You can read everything related to dysplasia in this material.

If a cytological examination or scraping reveals that you have STM, you should consult a doctor regarding sanitation (treatment of infection) of the cervix. After this, after about 3 months, you need to repeat oncocytology (preferably liquid cytology) and if the smear is again not normal (not nil), colposcopy and further examination are prescribed.

Explanation of terms from the cytogram

Koilocytes are modified cells characteristic of PVI or HPV (human papillomavirus), we wrote about them in detail here.

Neutrophils are a type of white blood cell.

Diskeratocytes, like koilocytes, are a sign of PVI.

Exocervix is ​​the mucous membrane of the vaginal part of the cervix.

Endocervix is ​​the tissue (mucous) directly of the cervical canal.

Hyperkeratosis is keratinization of the cervical epithelium. Many people consider this a precancerous condition, but this is not the case. If such a word is present in your cytogram, you need to do a colposcopy, and if the doctor finds an area on the cervix with presumably atypical cells, he will take a targeted biopsy from there. Further, treatment of the pathology is carried out depending on the histological result. In the case of an existing inflammatory process, all this must be done after treatment.

Leukocytes are cells in large numbers indicating inflammation. Ideally, doctors should first take a smear from the vagina to determine the degree of purity, and only then a cytological one, since the latter is informative specifically for healthy flora.

Red blood cells are blood cells. If they are in the results of your smear, it means that a small vessel was damaged during the collection of the material. When the cervical mucosa is inflamed, this often happens.

Elements of inflammation- signs of inflammation.

Mixed flora - the vaginal microflora contains both harmless microorganisms and pathogenic and opportunistic microorganisms. If there is a large number of leukocytes, treatment is required.

Rod flora- this is the absolute norm. The vaginal microflora is fine.

Jet genesis- There is no need to be afraid of the word “reactive”. This does not mean “fast”, “fast” and the like. This is not cancer or pre-cancer. This is a synonym for the word "reaction". That is, the reaction of cells to infection.

Ectopia - it is also called erosion (which is not true), pseudo-erosion, endocervicosis, border or transformation zone. This is the junction of two types of epithelium - multilayered, located on the vaginal part of the cervix or cylindrical - cells of the cervical canal. Throughout a woman’s life, this border migrates and moves inside the cervix with age.

Endocervicitis is inflammation of the cervical canal mucosa.

Atypia - cellular changes. They can occur both in oncology and inflammatory reactions. ASCUS - this just means the presence of cells of undetermined significance.

Anaerobic cells- bacteria that cause disease

Atrophic type of smear- this is how the lack of estrogen in the body manifests itself. Relevant for menopause. The mucous membrane of the cervix is ​​easily injured, thin, and bleeds.

Estrogen smear type- the norm for women of reproductive age.

HPV - human papillomavirus or human papillomavirus infection. With a bad cytogram, its oncogenic strains are usually detected - HPV types 16 and 18.

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Cytological examination in gynecology

Cytological analysis in gynecology refers to microscopic examination of samples taken from the vagina and cervical canal to determine the typical cellular composition. This diagnosis allows doctors to draw conclusions about the presence of inflammatory processes, precancerous diseases or cancer in the patient’s reproductive organs.

Unlike histological examination, the cytological method is non-invasive. That is, when taking biological material there is no need to perform a biopsy or puncture, and the integrity of the tissue is not compromised at all. Samples taken using a fingerprint or swab are analyzed. To obtain accurate results, you must carefully follow the rules for preparing for the examination. It is also very important that the analysis is deciphered by the woman’s attending physician, who will take into account her complaints and data from other diagnostic methods.

Cytological analysis usually takes no more than a day to complete. If a precancerous condition or an oncological process is discovered, invasive diagnostic techniques are used to clarify the diagnosis - biopsy.

Cytology is especially important when biopsy is contraindicated and when examining a large number of patients (when it is necessary to identify women at risk for developing malignant pathology).

A smear cytology (Pap test, Papanicolaou test) is a microscopic examination of a smear from the cervix for the purpose of early detection of cancer. This analysis is also called a hytological smear or oncocytology smear. This examination is easily tolerated by patients because it is completely painless and does not take much time.

A cytological smear not only makes it possible to timely diagnose cellular abnormalities, but also helps to identify the presence of unwanted microflora in the vaginal environment. At the same time, the test does not provide accurate data on the detected pathologies, and if an unfavorable result is obtained, the patient is sent for additional examination (smear for flora in women) and for testing for STDs.

Using the cytological method, which has been successfully used in gynecological practice for decades, it is possible to identify 5 types of changes in the cells of patients. Moreover, the research is very simple and affordable. Doctors advise all women aged 18 to 65 to undergo it at least once a year. Based on the results of the analysis, it is possible to reliably establish the presence or absence of any pathology.

Indications for smear cytology

It is advisable for all women to have a smear for cytology. Before the age of 40, it is enough to undergo such diagnostics once a year. Representatives of older age groups need to be examined once every 6 months. Some cases are mandatory indications for the test. These include:

— Inflammation in the cervical canal, cervix, especially if they occur chronically.

— Menstrual cycle disorders.

- Reproductive problems.

— Preparation for surgical interventions and other medical procedures.

— Planning pregnancy.

— Preparation for installation of the spiral.

— Taking hormonal drugs.

- Diabetes.

— 2nd and 3rd degree obesity.

— The presence of certain viruses in the body (human papilloma, genital herpes).

- Frequent change of sexual partners.

Contraindications for cytological examination

Cytology smears are not taken during menstruation. If you need to evaluate the presence of atypical cells, you should not conduct the analysis during inflammation of the vagina and cervix. The fact is that big number leukocytes will simply “close” the pathological cells, and it will be impossible to detect them using the cytological method.

Preparation for a smear for cervical cytology

To get the most accurate result, you need to follow a few simple rules:

- Do not douche.

— Do not use topical medications (suppositories, ointments, etc.).

- Wait until your period ends.

- Do not urinate three hours before taking a smear.

— Abstain from sexual intercourse for two days before the study.

If there is an inflammatory process in which a lot of secretion is released, the disease must be treated and a control smear done to confirm recovery. And only after this does it make sense to perform a cytological analysis.

An oncological smear is taken by a gynecologist when examining a patient. First, using mirrors, the doctor examines the condition of the vagina, examines the entrance to the cervical canal and the mucous membrane of the cervix. Then, material is taken for analysis from three areas (vagina, cervical canal, cervical inlet) using a special brush. The procedure takes very little time and does not cause patients any pain.
The collected material is placed on a glass slide, evenly distributed and, after drying, transferred to a medical laboratory. There, the smear is stained with special substances and examined under a microscope.

In this case, the following characteristics are assessed:

— Cell sizes and their structure.

— Number of cells (per certain unit of area).

- Mutual arrangement.

- Shape of the epithelium.

— The presence of pathological changes in cells.

Structures of multilayered squamous epithelium of the vaginal mucosa

A - basal layer (a - basal cells, b - parabasal cells)
B - intermediate layer, B - surface layer; on the right are individual cells of the corresponding layers of the vaginal epithelium.

After the material collection procedure, the patient can immediately return to her normal activities. Normally there should not be any discomfort, since the brush cannot injure the tissue. True, there is a possibility that a small blood vessel will be affected. Then, within 1-2 days after the analysis, slight bleeding (streaks) will be observed. This phenomenon should not cause concern to a woman.

Cervix healthy woman covered with columnar epithelium, and the vagina is flat. As for the vaginal microflora, it is not cocci, but rods. Some indicators depend on the phase of the cycle - karyo-pyknotic and acidophilic indices, basal and parabasal cells, the number of leukocytes. They provide information about the functioning of the ovaries.

Pap test interpretation

Depending on the condition of the epithelial cells, vaginal smears subjected to cytological examination are divided into five classes (Papanicolaou technique):

Class 1. Absence of pathological changes in the studied material. The cells are of normal size and shape and are correctly located.

Class 2. The morphological norm of some cellular elements is reduced, which is a sign of inflammation or infection. This result may be a sign of vaginosis. In such cases, further diagnostics are indicated to make an accurate diagnosis and select adequate therapy.

Class 3. The material contains single cells with disturbances in the structure of the nucleus and cytoplasm (dysplasia or hyperplasia). The number of such pathological cells is small. The patient is sent for repeat cytology.

Class 4. The examined smear reveals cells with malignant changes in the nucleus, chromatin and cytoplasm. These pathological changes indicate that the patient has a precancerous condition.

Class 5. The presence of a large number of atypical cells in the smear (much more than normal). In this case, it is diagnosed initial stage cancer.

Deciphering a smear for cytology using the Betsed method

Cytological analysis of material taken from the cervical canal is deciphered using the Betsed method. This takes into account the location of cells and dyskaryosis (changes in the nucleus). The results of the study may be as follows:

- Normal. The absence of pathology does not have any special designation.

— Vaginosis, koilocytosis – HPV.

- Cervical dysplasia depending on the degree - CIN I, CIN II or CIN III.

— Cervical cancer — Carcinoma (pax).

Terms in diagnosis for cytological analysis of a cervical smear

In gynecological practice, it is customary to use the following designations and terms to describe the results of cytological studies:

— CBO. Normal indicators, no pathological changes.

Cytogram of inflammation. Indicators indicating the development of the inflammatory process (cervicitis).

— Leukocyte infiltration – increased number of leukocytes. This is a sign of vaginosis, exocervitis or endocervitis.

— Koilocytes – the presence of cells indicating HPV.

— Proliferation – acceleration of cell division. This condition is typical for the inflammatory process in the uterus. With strong proliferation, advanced inflammation occurs.

— Leukoplakia – the smear contains pathologically altered (but not cancerous) cells.

- Metaplasia - one type of cell is replaced by another. It is considered normal for patients who were treated for non-cancer pathologies of the uterus during menopause. In addition, this condition is normal for women who have been in menopause for more than 6 years.

— Dysplasia is a precancerous pathology.

The following abbreviations are used to describe the results of an analysis of a smear containing atypical cells:

—ASC-US– the presence of altered squamous epithelial cells of unknown etiology. It most often occurs in patients over 45, when estrogen production decreases.

—AGC– changes in cylindrical cells, which may indicate vaginosis or any other diseases. This result requires additional clarifying diagnostics.

- L-SIL– the presence of a small number of atypical non-cancerous cells. In this case, the patient is referred for further examination (biopsy and colposcopy).

-ASC-H– pathological changes in cells that indicate precancerous pathology or an incipient oncological process.

—HSIL is oncocytology (altered flat cells are present). Such patients are given immediate treatment to prevent degeneration into a malignant tumor.

— A.I.S.– This abbreviation indicates that cylindrical malignant cells have been identified. With such results, urgent treatment is necessary.

If pathologically changed cells are detected in a smear, the laboratory assistant will definitely indicate this in a written report specifying the type of changes. If there are no special designations in the analysis transcript, then, in all likelihood, the smear corresponds to the norm. An accurate diagnosis cannot be made based on this test alone. To determine the nature of the pathology, the gynecologist needs to compare the results of different examinations.

How many days does a smear cytology test take?

Cytological analysis of a smear usually takes from 1 to 5 days.

It is important to remember that the oncological process does not occur in a few days. Quite a long time passes from the first pathological changes to malignant degeneration. Therefore, timely detection of atypical cells in a woman’s body makes it possible to prevent the development of cervical cancer. For these purposes, an accessible and simple method for the early diagnosis of malignant cells was introduced everywhere - a cytological examination of a smear.

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What can you see from a smear?

Usually, a smear on flora and cytology can show all the changes in the uterus and mucous membranes. When the doctor notices such changes, he will immediately prescribe appropriate therapy or additional testing.

After the examination, the doctor can make a conclusion. There are usually two options here. First, when the result is positive, it means that inflammation and cell atrophy occur in the uterus. The second is when the result is negative. In this case, the woman is healthy and will not require treatment.

Experts advise carrying out an inflammatory type of smear for cytology once or twice a year. Also, during such an examination, other pathologies in the vagina can be identified, which will make it possible to begin treating them in time and prevent the development of complications or the manifestation of oncology.

When should you take a smear test?

In order for every woman to be confident in her health, she must undergo a smear test regularly. But not everyone does this. Therefore, doctors have identified indications for which it is mandatory to visit a specialized doctor. This:

• Menstrual irregularities.
• Infection in the uterus.
• Planning for conception.
• Carrying out the operation.
• Installation of the spiral.

There are also risk groups. When a woman is one of these, she should also regularly visit a gynecologist and have him examined. These are the following groups:

• Obese.
• With diabetes.
• With genital herpes.

When a woman constantly changes sex partners, and also takes hormonal anti-conception drugs, or she simply has a weak immune system, then she should also think about undergoing such tests. You can refuse such examinations only in one case - when a young woman does not have sex and has not had a hysterectomy.

Preparation

To determine whether there is cervical cytology, such examinations must be carried out regularly. The best period for this, as doctors note, is cycle 15-20. But you should take a smear test only after your period stops. If a colposcopy was previously performed, you can take a smear on the second day.

To get the most accurate and reliable result, it is worth preparing for such a procedure. To do this you need:

• Do not have sex two days before testing.
• Do not take antibiotics for 7 days.
• Avoid taking medications that may affect the uterine flora. These can be sprays or candles. Also, you cannot use different lubricants.

Two hours before the procedure itself, you should not visit the toilet. This will require a little patience.

Sampling process

The ascus procedure is performed in a gynecologist's office on a chair. For testing, you need to prepare a spatula, a mirror and a brush. The doctor should take three swabs in 10-15 minutes. These are the strokes:

• From the walls of the uterus.
• From the cervix.
• From the cervical canal.

Typically, such an event does not cause negative feelings in the patient. But there are two points to pay attention to:

• If there is inflammation in the uterus, then any intervention can cause pain.
• For full testing and accurate results, it is important to take those tissues that are deeper, and not from above. Therefore, the doctor will have to apply some effort along the mucous membrane and pinch off part of it. This can usually cause discomfort.

Important! A certain category of women, after taking such samples, may feel discomfort when passing urine. But there's nothing wrong with that. Such symptoms will quickly go away on their own. If they are observed for a long time, then you should consult a doctor.

The fabrics obtained in this way are dried and sent to the laboratory for testing. There they are examined by a specialist under a microscope.

What can testing show?

When the doctor takes a smear, the laboratory technician must examine it carefully. At the same time, he draws attention to the following points:

1. Epithelium.
2. Cell size.
3. Cell location.
4. The number of elements in a stroke.
5. Changes in structure.

After testing, the doctor makes a conclusion and gives the result to the patient. Typically, it may take 1-2 days for the conclusion and examination of the results.

The doctor can give the patient a conclusion with the following results:

• Negative. No pathologies were found and the patient is healthy.
• Inflammatory. Additional tests are ordered to determine the cause of the infection. After 2-3 weeks, the woman is sent for re-testing.
• Abnormal cells. This will require microbiological testing. The result can be drawn from the data received. Here, too, over time the woman will need to take additional tests.
• Oncology. Other methods are prescribed to clarify the diagnosis.

Doctors also say that tissue testing results can only show what changes are happening in the body. Therefore, a diagnosis is made only based on such results. If the doctor suspects a disease, he will prescribe an additional examination.

What causes cells to change?

Various ailments can result from this pathology. The most popular cause is thrush. There are also other diseases. This:

1. Chlamydia.
2. Papillomas.
3. Gonorrhea.
4. Trichomoniasis.

Using a smear, the doctor can only see certain changes that have occurred in the body. If such are identified, then other tests must be prescribed to make an accurate diagnosis.

Pregnancy and smear

During pregnancy, a smear can be taken at least three times throughout the entire period. In this condition, it is important for the doctor to identify not only cytology when taking a smear, but also to determine the presence of other pathologies, if any, in the body.

There are a huge number of different methods for examining gynecological problems. One of them is a cytogram. This is a study of vaginal epithelial cells. It is performed in a laboratory and the smear is taken by a doctor. How to decipher the results, and what does a cytogram of inflammation mean, how serious is it, and how to treat it?

Why do you need a cytogram and how to get tested?

The pelvic organs consist of various types cells, sometimes from several layers. When inflammatory or other pathological processes occur, cells uncharacteristic for this area may be detected. This is one of the first signs that the disease is developing. The sooner a problem is detected, the faster and more effectively it can be eliminated with minimal negative consequences.

In order to take a cytogram, a woman must prepare. This is very important to ensure that the data obtained is as reliable as possible. The preparation is not difficult, but it must be approached as responsibly as possible. This is in the interests of the woman herself. When a gynecologist prescribes a cytogram for a woman, he informs her about how to prepare for this:

• a woman should not use hormonal contraceptives for some time before taking the test;
• within 2 days before taking the cytogram, it is necessary to abstain from sexual intercourse, both protected and unprotected, because this will also affect the results of the analysis and their reliability;
• you can’t douche, because this will also distort the picture;
• it is undesirable for a woman to undergo gynecological examinations on a chair shortly before taking the test, because such “external interference” can also distort the results;

Strong inflammatory processes vaginas can also cause distortion of the results.

How is a smear taken? Samples are collected using a special gynecological “brush” in the area of ​​the cervix and cervical canal. That is, two smears are taken, because it is in these places that the epithelial cells of the vagina accumulate. To do this, the doctor uses a special mirror to take samples exactly where it is required, and then applies a smear to the glass for examination.

A cytogram can help identify various diseases:

• abnormal development of the cervix;
• STI;
• inflammatory processes of the uterus and cervix;
• changes that occur in tissues after menopause;
• neoplasms in the cervix;
• cervical erosion, etc.

Of course, if you suspect the presence of one of the above diseases, you will need additional tests and examinations.

During laboratory research, cells are stained using special methods. This allows you to identify the nuclei and cytoplasm of cells. It is very important that the analysis is carried out by a qualified cytologist, and that modern techniques and equipment are used to obtain the most reliable information. Usually, when sending for a cytogram, the gynecologist indicates in his direction the disease he suspects. The cytologist, after performing the analysis, confirms the diagnosis or refutes it. But, even if the diagnosis suggested by the gynecologist was not confirmed, but the cytogram reveals other problems, the cytologist indicates this in the conclusion.

A specialist in a laboratory under a microscope studies the type of cells, examines the epithelial cells on different layers, counts their number, pays attention to the shape, shape and size of the nucleus, the clarity of the boundaries, etc. All this can provide information about the presence of a particular pathology, viral or infectious process. As a result, one of the options is indicated in the transcript for the cytogram: negative or positive. If this is a negative option, then there are no problems and everything is within normal limits. If the result is positive, this indicates the presence of abnormal cells in the epithelium, which may differ in size, shape, nuclear size or some other non-standard structural features.

Cytogram without features: what does it mean?

This means that the number of epithelial cells, their shape, size and other characteristics are within normal limits. All this suggests that there are no problems. Although, this also cannot be a 100% guarantee that there are no problems at all. Sometimes cytology results can be distorted if an incorrect smear was taken, or the woman ignored the rules for preparing for the test.

Usually, in the case of a cytogram with signs of inflammation with reactive or degenerative changes in the epithelium, based on one analysis, a diagnosis is not made, because the disorders can be complex. For example, if it is papillomas, the nucleus of the epithelial cells may be increased in size. But such changes can also be detected with other problems. Therefore, when making a diagnosis, the gynecologist takes into account not only the results of the cytogram, but also the patient’s age, the phase of the menstrual cycle when the smear was taken, concomitant diseases, anamnesis, complaints, other symptoms and the results of a visual gynecological examination on the chair. Therefore, treatment is prescribed in accordance with the diagnosis made on the basis of all the above factors.

Cytogram of bacterial vaginosis

Bacterial vaginosis - common problem, which occurs in women of reproductive age and during menopause. Some gynecologists do not prescribe a cytogram in the presence of this disease, believing that due to heavy vaginal discharge, the test results will be incorrect and unreliable. Other doctors, on the contrary, specifically order a cytogram to confirm the diagnosis. One of the main signs is that gardnerella are found on the surface of epithelial cells. After making sure that it is bakvaginosis, the doctor prescribes appropriate treatment.

How a cytogram is performed and what to do after receiving the results, watch the video: