Liquid Cytology Dad Test Decryption. Cytological examination of cervical scrapets and cervical canal (painting by papanicolau, rar test)
Cervical cancer Does not arise suddenly. This disease gradually arises from various precancerous pathologies and progresses very slowly for several years. Therefore, in the case of early detection of pathology, the chances of complete recovery are very high. This is especially true of numerous precancerous diseases, which today are very good to treat with the use of the latest methods and technologies.
Cytological Research Shacking Matter (PAP Test) - This is a modern method of early diagnosis of precancerous changes at the level of cells.
As a screening research, this analysis allows to reduce the disease of the cervical cancer by 84%.
Why is the analysis of cytology?
The study is carried out primarily in order to make sure that the cervix is \u200b\u200bhealthy.
As a rule, in 90% of cases, the test confirms the absence of diseases.
In 10% of women, various pathologies are detected, which can be treated with the outcome of complete recovery.
Simple ambulatory therapy for precancerous changes prevents the development of a serious disease.
Subject to regular analysis, a woman practically negates the risk of cervical cancer.
Indications for analysis.
Preventive inspections and screening research.
Suspicion of atypical processes (dysplasia) cervical epithelium.
All women older than 35 years at least once a year.
Women from risk groups.
The risk factors for the development of cervical cancer include
the presence of human papillomas in the body of oncogenic viruses (HPV);
chlamydial and herpetic infection;
chronic inflammatory gynecological diseases;
frequent change of sexual partners;
early start of sexual life;
hereditary factor (cervical cancer in close relatives);
long-term use of hormonal contraceptives;
frequent numerous childbirth;
How is the taking of biomaterial for analysis?
Cytological material from the mucous membrane of the cervical cervix takes the scuffery method. Scales are carried out by special brushes from different parts of the cervix and placed on the slide.
In order for the material of the material in the process of the material, extraneous fabrics, with the taking of the material, special mirrors are used.
The doctor quickly inflicts biomaterial on the glass to prevent drying, then the material is immersed in a special solution and sent to the laboratory.
Cytological examination of the cervical cervix carries the name of the PAP test named Jords Papincolau's scientist.
In the laboratory, the laboratory provides staining of the smear in several stages according to the method of Papincolau, after which it estimates the degree of ripening of the cytoplasm of the epithelium cells and reveals the presence of atypical.
In very rare cases, the inadequacy of the material taken can be revealed. Then the laboratory will simply ask to repeat the sample.
When can a distorted analysis result?
First of all, the distorted result can be obtained if the woman prepared for analysis is not properly.
biomaterial for analysis taken during menstruation and in the smear there are blood;
in the smear there are spermatozoa;
in the smear, extraneous impurities were found: spermicidal creams, grease for condoms, gel lubricant for ultrasound;
the doctor conducted a study by the method of palpation to take the analysis, so the biomaterial is polluted by Talc.
As for girls up to 20 years, they can find false-positive changes against the background of hormonal shifts.
How to prepare for the delivery of analysis on oncocytology?
Compliance with several fundamental preparation rules for analysis is a prerequisite for obtaining reliable results.
the biomaterial is taken at no earlier than 5 days of the menstrual cycle. In any case, bleeding must completely end.
The analysis is carried out no later than 5 days before the expected time of the coming of the next menstruation.
The test is produced no earlier than 24 hours after sexual contact.
If the woman enjoyed Lubricants, hesitated medicines into the vagina, creams, dried with various solutions, used tampons, then from the moment such manipulations should pass at least 48, and better than 72 hours.
The same period of time must pass after an ultrasound study by the vaginal sensor.
There is a slight chance of a negative result of cytology with the modified states of the epithelial cervix layer, so regular tests are needed once a year.
Classification of the results of analyzing cytology
1 class. Anomalous cells in the smear are not found, a healthy cytological situation.
Grade 2. Inflammation of various etiologies lead to a violation of the structure of the cell.
Grade 3. Detected single modified cells. In this case, the diagnosis must be clarified, therefore, a re-cytological study is usually carried out or a biopsy of the modified sections with subsequent cytology.
4th grade. Separate atypical cells were found with signs of malignancy.
Grade 5. Analysis has a large number of atypical cells.
Currently, a more modern and progressive study method is liquid thin layer cytology. This is, of course, more costly and therefore an expensive diagnostic method, but at the same time more sensitive.
The sensitivity indicators of the traditional cytological research range from 35 to 89%, while the sensitivity indicators of liquid cytology are 71-95%. Such criteria allow us to take an analysis on cytology less often - once every two or three years.
Padnicolau smear, or Papanicola Test and (English, Pap Test)- A test with which you can define precancerous or cancer cells in the vagina and the cervix. The main difference from the standard cytological study is to further fix the material with alcohol when cooking glass, which increases the accuracy of the analysis.
Scrap is performed from two points: cervical canal and cervix.
Pap testt. It makes it possible to effectively effectively identify the prejudition changes of the epithelium - cervical intraepithelial neoplasia of varying severity.
This type of study is mandatory for women older than 30 years, especially those who have previously been detected or currently detected by human papillomavic viruses of high-oncogenic risk, as well as for women who have discovered the zones of the altered epithelium with a coloscopic examination of the cervix.
The number of drugs (glasses) can be from 1 to 3. Most often it is necessary to explore two drugs - epithelium from endocervix and extocereservix. Material fence must be made using special calves.
Indications:
- screening cervical cancer.
In women reproductive age, the smear is desirable to take no earlier than the 5th day from the beginning of the menstrual cycle or no later than 5 days before the alleged start of menstruation.
24 hours before taking, it is necessary to abandon the use of vaginal medicines, spermcides, lubricants, exclude sexual contacts. You can not paint on the eve of the smear.
If there is a visual pathology on the cervix, the smear must be taken regardless of the above factors.
* Please note that children under 16 gynecological analyzes are taken only in the presence of parents. In medical offices, do not make scraping and smears from the cervical canal to pregnant women with a period of 22 weeks and more, since this procedure can cause complications. If necessary, you can refer to your doctor.
Interpretation of results
First, the quality of the smear is estimated: high-quality, poor quality. If the quality of the smear is unsatisfactory, the smear must be repeated. Papinicolau smear can be positive or negative (I class on Papanicolau).
There are no atypical cells, all cells of the same shape and sizes (negative dad-smear). The presence of different cell form and sizes, their pathological position is characterized as a positive smear by papanicolau. The results of these analyzes show the presence of atypical cells, which often sounds frightening for women who do not understand what it means.
A positive result of the smear on atypical cells means not that you have cancer or a precancerous condition, but only indicates the need for further research. The reason for the appearance of atypical cells may be inflammation (chlamydia, herpetic infection, gonorrhea, trichomoniasis), infection with the human papilloma virus (HPV). These changes are more often characterized as dysplasia II degree. In this case, it is necessary to carry out the necessary treatment and repeat the smear in 3-6 months. When papillomavirus infection is often detected by cellocytosis of cells. Coilocyte 3 cells of the flat epithelium of irregular shape, with clear boundaries. The sizes of coylocyte various, usually they are greater than normal cells. The nuclei is increased in different degrees, the nuclear membrane is uneven, folded. Around the core marks the enlightenment of the cytoplasm.
Cytological classification by Papanicolau
1st grade is a normal cytological picture;
2nd class - change of cell morphology due to the inflammatory process in the vagina and (or) cervix;
3rd grade - single cells with nuclei anomaly and cytoplasm (suspicion of malignant neoplasm);
4th grade - individual cells with obvious signs of illustrative;
The 5th grade is a large number of typical cancer cells. The diagnosis of malignant neoplasm is no doubt.
Bethesda classification
When classified by the BetheSda system (The Bethesda System-TBS), the following terms may meet in conclusion of a cytologist:
- ASCUS (Atypical Squamous Cells of Undetermined Significance) or APPS (atypics PlateClaid uncertain significance);
- CIN (CERVICAL INTRAEPITHELIAL NEOPLASIA) or QIN (cervical intraepithelial neoplasia) (term is used as synonymous cervical dysplasia);
- LSIL (LOW-GRADE Squamous IntraePitelial Lesions) or H-PIP (flat-butter intraepithelial lesion of low severity);
- HSIL (High-Grade Squamous IntraePitelial Lesions) or B-PIP (flat-belling intraepithelial damage to high severity).
The protocol of standardized cytological conclusion consists of the following sections:
1. Quality of the drug:
- adequate;
- inadequate.
- epithelial cells within the normal range are replaced by negative in intraepithelial pathology or malignancy;
- describes the pathological changes of the epithelium.
a) Atypic flat cells (ASC):
- PKNS (ASC-US) of an indefinite value - reactive changes or dysplasia I-weak-Qing-1, most often associated with inflammation;
- non-exclusive in PIP (ASC-H);
- low degree of flat-belling intraepithelial lesions (Lsil);
- H-PIP-Qing 1 (I-light dysplasia), papillomavirus infection-HPV;
- high degree of flat-belling intraepithelial lesions (HSIL);
- Qing 2 (dysplasia II-moderate), Qing 3 (dysplasia III-pronounced), cancer in situ;
- flake carcation cancer.
- without additional characteristics;
- cells are suspicious on invasion;
- endocervical adenocarcinoma in situ; - adenocarcinoma.
5. Additional refinements: indicate a specific infectious agent (when discovered).
Description
Definition method Microscopy
The material under study See the description
Available Departure to the house
Padnicolau staining method is a specially designed method, allowing the greatest degree of reliability to identify early precancerous diseases of the cervix.
The cervical cancer in the structure of malignant neoplasms of the reproductive system ranks third. Until 1992, the incidence of cervical cancer decreased, but now the tendency to increase this pathology is again observed. The development of the tumor occurs gradually for several years, therefore, preventive inspections of women using the cytological method of research are very important.
Currently, when conducting screening programs for the detection of cervical cancer, precancerous and background states, the cellular material for papanicolau - RAP test is used. Padnicolau staining method allows you to evaluate the degree of ripening of the cytoplasm, well stains the kernels with atypics. The term "Atiphy" has different interpretation in different countries: in Central Europe, it determines as malignant, in the WHO nomenclature - "less than dysplastic intraepithelial changes".
Conducting a rar test has a number of features. An important point is the correct taking of the material and its fixation. Cellular material is taken by brushes of a special configuration in "mirrors" to avoid hindrances. Material transfer must occur quickly, without drying; Fast fixation of a wet smear of 96% ethanol is necessary. Padnikolau smears staining passes a number of stages, then the cellular material imprisoned in balm is subjected to cytological analysis.
The material under study: ignitions from endocervix, extocereswix, as well as mixed scales applied to the glass glass.
Literature
- Kulakov V.I. et al. "Modern approaches to the diagnosis of papillomavirus infection in the genitals of women and their importance for screening cervical cancer. Gynecology". 2000; 1 (2): 4 - 8.
Preparation
No special preparation for research is not required. Please note that children under 16 years old gynecological analyzes are taken only in the presence of parents. In medical offices, do not make scraping and smears from the cervical canal to pregnant women with a period of 22 weeks and more, since this procedure can cause complications. If necessary, you can refer to your doctor.
Interpretation of results
The interpretation of research results contains information for the attending physician and is not a diagnosis. Information from this section cannot be used for self-diagnosis and self-treatment. The exact diagnosis is made by the doctor using both the results of this survey and the necessary information from other sources: anamnesis, the results of other surveys, etc.
The protocol of standardized cytological conclusion, based on the classification of Bethesd (revision of 2001), as well as on a standardized cytological description according to the order of the Ministry of Health, consists of the following sections:
- quality of the drug: - adequate;
- citogram / Description: - epithelial cells within the norm replaced by - negative on intraepithelial pathology or malignation;
- cytogram / Features: The main categories of pathological changes of the epithelium:
- cytogram / Other types: Other non-torrent changes (when detected);
- additional refinements: A specific infectious agent is indicated (when it is detected).
- inadequate.
Either described the pathological changes of the epithelium.
a) atypical flat cells (ASC)
- PKNZ (ASC-US) - undefined value - reactive changes or dysplasia I-weak-Qing-1, most often associated with inflammation;
- non-exclusive B-PIP (ASC-H);
- Low degree of flat-belling intraepithelial lesions (Lsil): - H-PIP (ASC-H) - Qing 1 (dysplasia I - light);
- Papillomavirus infection - HPV;
- High degree of flat-belling intraepithelial lesions (HSIL): - B-PIP (ASC -B) - Qing 2 (dysplasia II -ymal), Qing 3 (dysplasia III-pronounced), cancer in situ. - flat-belling cancer;
b) Atypic glands (AGS)
- without additional characteristics;
- Suspicious cells for invasion;
- endocervic adenocarcinoma in situ;
- adenocarcinoma;
Cervical cancer occupies 3-4 place in the prevalence of malignant processes among women. In the early stages, the disease is 100% curable.
The method of liquid cytology with painting by papanicolau (dad-test / rar-test) is recommended by the World Health Organization as the "Gold Standard" diagnosis of cervical cancer. Its effectiveness is 95%, while the sensitivity of traditional techniques does not exceed 40% in some cases. Pap-test helps to identify the disease even when clinical symptoms are still missing. Cervical cancer has a long development period - on average 10-15 years old, and therefore, severe illness can be avoided! From the moment when the pa-test was introduced into medical practice (in 1950), women's mortality from cervical cancer fell 10 times.
Most often, the cervical cancer occurs in women aged 45-55 years, in postmenopausal women, aged after 65 years. However, there is data on increasing the increase in incidence among women under 30 years old. Moreover, in 18% in this age group, after screening, the disease is found already at the later stage when treatment may not be so effective.
The purpose of the PAP test is to identify cancer in situ, that is, the "0th" stage cancer. It helps to assign effective "saving" treatment, reduce its timing, avoid complications.
For research, they take scraping from the surface of the cervix and cervical canal, as well as from the transformation zone, in which the pathological process occurs most often - up to 80%, which is the advantage of the study by liquid cytology.
Cytological classification by papanicolau:
- 1st class - Normal cells;
- 2nd class - change in the shape of the cells due to the inflammatory process in the vagina and / or the cervix;
- 3rd grade - there are single cells with nuclei anomaly and cytoplasm (suspicion of malignant neoplasm);
- 4th grade - there are separate cells suspicious about malignancy;
- The 5th grade is a large number of typical cancer cells.
Pap-test is recommended for all women reproductive age, starting from 21 years. It is recommended to perform it every two years, it is necessary in the presence of gynecological pathologies of viral nature (pointed condylomas, genital herpes), long-term admission of contraceptive and hormonal drugs, the appearance of atypical seals from sex tract, infertility. With the negative results of the dad test, it is performed once every three years.
How to prepare for dad-test?
Recommended the analysis is recommended no earlier than on the 5th day of the menstrual cycle and no later than 5 days before the start of menstruation. On the eve and on the day of study, do not dock the vagina, and for 2-3 days to exclude the use of fat-containing vaginal preparations (candles, creams, vaginal pills). During menstruation, as well as earlier 24-48 hours after sexual contact, intravaginal ultrasound and colposcopy, the pick of the smear is not carried out!
To eliminate the risk of developing this serious illness, take care of your health, sign up for a gynecologist in Citalam and perform a dad-test based on the liquid cytology method - 90-69-502 - a cytological study of the scrapets of the cervix, cervical canal, vagina with color Papanicolau (material taken into a liquid transport environment).
Papers Cytological Magnifier Papinicolau, Pap-Test (recommendations for women)
Cytological (cervical) smear ( None name - analysis of papanicolau, dad test) - Simple, fast and painless examination for the patient. It is carried out during the inspection on the gynecological chair. With the prophylactic goal of the smear is made every year, since the beginning of her sexual life.
Mask Master Objective - identification of those changes in cervical cells, which can later grow into cancer. In the event that a woman addresses a gynecologist regularly, the changes are fixed at the earliest stage. In addition to the diagnosis of cell anomalies, the smear shows the presence of a number of pathogenic microorganisms into the vagina and allows you to determine the condition of the mucous membrane. The results of the smear often do not allow the final diagnosis and require other examination techniques.
Cytological smear is taken from three sites Vagina mucosa:
- from his arches,
- with the outer surface of the cervix and
- from the cervical channel.
This uses a special spatula. After taking, each sample is applied to the glass, and then sent to the cytological laboratory. There, the smears are studied in detail for the presence of deviations in the structure of cells. For this, it is used by painting by the Papanicola method, drying, examination under the microscope and so on.
How often do you need to repeat the procedure for taking a cytological smear?
Opinions of doctors on this issue are divergent. In most cases, the cell is required for about 10 years so that cancer tumor is formed from light changes. Therefore, part of the doctors indicates the lack of need to conduct a study often. But, at the same time, there were cases and rapid development of the disease. From here Recommended Sailing Frequency is once a year or a year and a half .
Cervical cancer (cervical cancer) is the second most common cause of death from oncological diseases and mortality of women around the world. The best way to detect cervical cancer is regular dadnikolau tests, or dad smears. Padnicolau smear is based on a microscopic study of cells taken from the cervix.
In the smear of Papanicolau, viral infections can be found (for example, human papilloma virus [HPV]) and other provoking cancer factors. Timely treatment can stop cervical cancer before it completely develops. A woman can have cervical cancer and not know about it, because the cancer often proceeds asymptomatic.
Matter Cancer Risk Factors:
- Several sexual partners (or sexual partners who have several partners)
- The beginning of sexual life at an early age
- Viral infections such as HPV, human immunodeficiency virus (HIV), or herpes variety virus (HSV)
- Weakened immune system
- Availability in the past sexual cancer
- Smoking
Screening cervical cancer woman is recommended annually, starting from 18 years old, or when it becomes sexually active, if younger than 18 years old. A woman with a negative result of Papanicola's smear for 3 years can be examined less often if it does not have sex contacts during this period.
The upper age limit for screening does not exist because the incidence of cervical cancer increases with age. Very often, cancer is diagnosed with women over the age of 50. Even after menopause, a woman must systematically make Papanicola smear.
Many older women believe that they no longer need Pad smear, think that they are not at risk of developing cervical cancer due to their age, because they cannot be sexually active. This is not true. These women need Pad smear, because their risk is higher. Even if the woman's uterus is removed, it should conduct an annual annual screening on cancer, if there are abnormal silent results in papanicolau or oncological diseases of the sexual system in history.
Complications of smear Papanicolau
The procedure for taking a smear of Papanicolau is not complex and painful. The only risk is the undetection of the cervical cancer and its late treatment.
Preparation for smear Papanicolau
The best time to smear Papanikolau is any time without menstrual secretions. 2 days before the start of the test, you need to avoid the following events, as they may disguise the abnormal cells and lead to false negative results of the smear:
- Sexual intercourse
- Sprinting
- Application of vaginal (except to the doctor's discharge)
- The use of vaginal contraceptives (contraceptive foam, creams or jelly).
Patty Take Procedure
Taking a smear of Papanicolau, as a rule, is part of the gynecological examination and is accompanied by a chest survey, performed by an obstetrician-gynecologist. Saving a smear will take only about 1 minute from the total inspection time.
Woman lying on a gynecological chair on his back, knees are raised, and the legs are fixed in stepping. The doctor will use a small metal or plastic tool, called the mirror to open the vagina so that the walls of the vagina and the cervix can be clearly seen. 
In the photo - taking a cervical canal
A sample of mucus and cells will be obtained from the cervix (parts of the uterus, which goes into the vagina) and the mucous membrane of the cervical canal (inside the cervix) with a wooden scraper or a small cervical tassel. The sample of cells is evenly distributed over the glass and is fixed by the retainer.
In the photo: applying the material by the rash for the slide
This sample is sent to the laboratory for a thorough study under the microscope. If the doctor uses a new look of Papanicolau's smear called Thin-Prep test, the sample is washed into the vessel and goes to the laboratory for examination. The cytologist considers both types of tests.
- If a woman has an abnormal repetition of the smear of Papanicolau, the smears must be taken by a doctor in 4-6 months for 2 years before receiving 3 consecutive negative tests.
- If the positive feedback of Papanicola is obtained due to infection, it is necessary to treat the main reason. Pap-test should be repeated for 2-3 months, because cervical cancer can be hidden by infection.
Although Papanicola's smear is the best method of early detection of cervical cancer, this system is not perfect because even the best laboratories can miss some cell changes, the woman should pass the smear annually.
Recently, 2 computerized systems (PapNet and AutoPap) were approved in the United States to detect the anomalous cells of Papanicola's smear. To ensure the accuracy of the test, they use computer technologies rechecking dads in which abnormal cells may not be detected by a cytologist. These tests are more expensive than the cost of the usual smear of Papanicolau, but they can be useful if a woman has a high risk of cervical cancer.
Interpretation of smear results
Properly interpret the results of the smear is able to only a specialist doctor. In modern practice, the assessment of changes in the cells of software, the so-called method of papanicola, when allocated Five stages of the development of pathology.
1 Stage: Cells with any deviations are missing, there is a normal cytological picture. This stage is characteristic of completely healthy women.
2 Stage: There are small changes in the structure of cells caused, however, the inflammatory process of internal genital organs. This stage is also the norm, but at the same time, the doctor necessarily benefits you a more thorough examination for the identification of the causes of inflammation and eliminate them.
3 Stage: There are cells with anomalies in the structure of the nuclei, but their number is extremely small. In this situation, it is necessary to repeatedly take a smear or conducting a special histological examination of the modified tissue.
4 Stage: Separate cells can be found with obviously malignant changes (such as the increased mass of cell cores, changes in chromosomes and cytoplasm). At the same time, this gives reason only to suspect the disease, and not to put the final diagnosis.
5 Stage: A large number of typical cancer cells are observed in the smears.
The accuracy of cytological smears from the vagina is high (dad-test) when it comes to changes in the cervix. However, this analysis does not mean anything about the state of the uterus itself, ovaries or uterine pipes. And in 20-30% of cases of dad test False-negative results. The guarantee of a reliable interpretation of the data gives only a comprehensive examination (cervical colposcopy, the biopsy of the mucous membrane, etc.).
Most laboratories in the United States use Standard Terminal Set Classification Betar (cervical and vaginal cytological diagnosis) for the report or interpretation of the results of the smear of Papanicolau. By Classification of befaire Papinicolau smear samples that do not have abnormal cells are interpreted as a "negative result of intraepithelial or malignant lesion" (that is, women do not have cancer).
Samples with cellular disorders are divided into the following categories (as indicated at the National Institute of Cancer (USA):
- ASC (Atypical flatclellular cells): flat-cell cells Thin, flat cells that form the surface of the cervix. Co-start system
divides this category to the following 2 groups:
- ASC-US. (Atypical flatclellular cells of uncertain significance): PlateLock cell cells are not completely normal, but doctors are not sure that the changes mean cancer. Sometimes these changes are associated with HPV infection. ACS-US is considered soft anomalies.
- ASC-H. (Sypical plane cell cells can not be excluded flatwakellic intraepithelial lesions): cells are not normal, but doctors are not sure that the changes mean cancer. ASC-H often means a precancerous state.
- AGC (atypical gland cells): gland-free cells-production-producing cells found in the endocervical channel (in the center of the cervix) or in the mucous membrane of the uterus. Irony cells are not normal, but doctors are not sure that cell changes mean.
- AIS. (endocervical adenocarcinoma): precancerous cells in iron fabric.
- Lsil. (Weakly sprinkled flat-belling intraepithelial lesions): Low-class means that there are some early changes in the size and shape of the cells. The word of the lesion refers to the region of anomalous tissue. Intraepithelial refers to a layer of cells that form the surface of the cervix. Lsils are considered insignificant deviations as a result of HPV infection.
- Hsil. (Librated flat-belling intraepithelial lesions): Bright means that there are more noticeable changes in the size and form of abnormal (prejudice) cells, that is, cells are very different from normal cells. HSILS is characterized by more serious deviations and have a higher probability of cancer progression.
When should be addressed for medical help
Early stages of precancerous cervical diseases and cancer often do not have signs or symptoms. Therefore, it is very important to do regular papanicola strokes. Usually appear when cancer progresses and it is already difficult to stop it.
With the following symptoms, immediately consult a doctor:
- Unusual vaginal discharge
- Blood stains or light bleeding, in addition to the usual period of menstruation
- Bleeding or pain during sex
These symptoms are uniquely denoted by cancer, these symptoms can also cause other factors, but check is necessary to determine the cause.
If the result of the smear of Papanicolau is normal, the woman will continue the routine screening.
If its papanikolau is the result is atypical (could not be qualified as normal or abnormal), the re-smear must be made in 4 months. If the re-test is abnormal, the doctor will make colposcopy. During this test, the doctor looks at the neck of the uterus through the Colposcope tool (a special microscope), is looking for an explanation of the anomalies in Papanicola's smear. It does not painfully hurt and does not have side effects. It is possible to perform this procedure during pregnancy.
If there are abnormal cells on the cervix, the doctor will perform a biopsy (will take a sample of fabric to view under the microscope).
If the result of a smear of a woman is abnormal, colposcopy and biopsy should be carried out immediately. The biopsy is the only way to determine the prejudice state, cancer or its absence.
Several types of biopsy is carried out under various kinds of anesthesia.
For the treatment of precancerous fabric states or at a very early stage of cancer, the doctor can remove abnormal fabrics completely during biopsy.
If the results of biopsy and papanicolau are normal, Papanicolau smear must be executed again after 4 months.
If the biopsy is the norm, but Papanicolau is not the norm, the doctor will repeat the colposcopy and biopsy.
If the biopsy result is intraepithelial neoplasia or cancer, you need to immediately begin treatment from cervical cancer.
Important recommendations:
1. All women leading a sex life or over 19 years old are recommended once a year to undergo a gynecological examination with cytological analysis of Papanicolau smear (dad-test). After a negative result is received twice, you can pass this analysis less often - once every three years, up to the achievement of sixty-five years
2. If a woman uses hormonal contraceptives or transferred genital herpes, it is recommended to make a smear papanicolau twice a year.
3. Infertility, uterine bleeding, overweight (obesity), genital herpes, genital warts, a frequent change of sexual partners, receiving hormone-estrogen are factors for more frequent cytological smear.