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Cervical cancer screening is not that simple, these tips can help you improve the quality of sampling

Cervical cancer screening is not that simple, these tips can help you improve the quality of sampling

  • Categories:Industry News
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  • Time of issue:2018-12-21 09:46
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(Summary description)Cervical cytology has always been a powerful assistant in cervical cancer screening. It refers to taking a small amount of cell samples from the neck of the uterus and placing them under a microscope to observe the tiny early changes of cervical cells. The proposal of this technology can be sniped before the cancer has occurred, thereby greatly reducing the death rate of cervical cancer. Although some countries now propose to use HPV as a primary screening method for cervical cancer, cervical cytology is still irreplaceable.

Cervical cancer screening is not that simple, these tips can help you improve the quality of sampling

(Summary description)Cervical cytology has always been a powerful assistant in cervical cancer screening. It refers to taking a small amount of cell samples from the neck of the uterus and placing them under a microscope to observe the tiny early changes of cervical cells. The proposal of this technology can be sniped before the cancer has occurred, thereby greatly reducing the death rate of cervical cancer. Although some countries now propose to use HPV as a primary screening method for cervical cancer, cervical cytology is still irreplaceable.

  • Categories:Industry News
  • Author:
  • Origin:
  • Time of issue:2018-12-21 09:46
  • Views:
Information

  Cervical cytology has always been a powerful assistant in cervical cancer screening. It refers to taking a small amount of cell samples from the neck of the uterus and placing them under a microscope to observe the tiny early changes of cervical cells. The proposal of this technology can be sniped before the cancer has occurred, thereby greatly reducing the death rate of cervical cancer. Although some countries now propose to use HPV as a primary screening method for cervical cancer, cervical cytology is still irreplaceable.

  Pap smear and cervical liquid-based cytology should be distinguished

  There are currently two methods of cervical cytology: cervical smear and cervical liquid-based cytology. The principles are the same. Both are to observe the changes in cervical cytology under a microscope after sampling.

  Sampling of the cervical scrape is to use a wooden scraper to rotate around the cervix for one or several weeks to scrape the mucosa and secretions there. Then spread the removed secretions evenly on the numbered glass slides, immediately fix them in 95% ethanol for 15 minutes, and then stain them with the Pap stain.

  From the point of view of the sampling process, the wooden scraper used in cervical scraping is difficult to get the specimen of the scale-column junction in the cervical canal, and some studies have found that up to 80% of the cell sample will remain on the scraper and be discarded .

  Liquid-based cytology is a liquid-based thin-layer cell detection system to detect cervical cells and perform cytological classification diagnosis. It is currently a more advanced cervical cytology technology in the world. Use a special small brush (the middle bristles are longer than the side bristles) for sampling. The longer part of the bristles extends into the cervical canal, and the shorter lateral brush takes both sides of the outer cervix. Finally, the brush head is rinsed in a vial containing a cell fixative solution or directly placed in the vial.

  Whether it is cervical scraping or TCT, sampling is done manually. It is inevitable that various problems will occur during sampling, which will lead to a decrease in cytological satisfaction rate and affect diagnosis rate. Therefore, learning how to improve cervical cytology sampling is extremely important for obstetricians and gynecologists.

  The key to improving the quality of cell sampling is to obtain more cells. In March 2017, the Chinese Journal of Obstetrics and Gynecology published an article "How to Improve the Quality of Cervical Cytology Sampling", which is very useful for reference. Let's learn together:

  It is important to find the right sampling site

  The transformation zone is the metaplasia area of the cervical epithelium. It is the site of cervical intraepithelial neoplasia and carcinogenesis. It is also called the squamous column junction. The transformation zone is the target of cytological sampling, and it is best to sample near the junction of the new squamous column, taking into account the cervix vagina, cervical canal and suspicious parts.

  The original or congenital squamous-column junction of women of childbearing age gradually moved outward, and the columnar epithelium was exposed to the vagina, and over time was replaced by squamous epithelium, creating a new squamous-column junction that can be moved back to the cervical canal . The entire area between the original scaly column junction and the new scaly column junction is called the transformation zone, as shown below:

  

Cervical cancer screening is not that simple, these tips can help you improve the quality of sampling

    Figure 1 The transformation zone of postmenopausal women returns to the cervical canal

 

  After menopause, the squamous-columnar junction of most women will retreat into the cervical canal and cannot be seen directly by the naked eye, as shown in Figure 2. Therefore, postmenopausal women should pay special attention to the area of the cervical canal when sampling.

  

Cervical cancer screening is not that simple, these tips can help you improve the quality of sampling

    Figure 2 The transformation zone of females of childbearing age, as shown by the arc arrow in the figure, and the green area is the sampling area

 

  Clinically, when the cervix is small, the cervix is displaced (especially after cesarean section in young women), the cervix is atrophy after menopause, or the cervix is deformed after treatment, and the transformation zone cannot be seen, cervical forceps can be used Clamp the cervix or find the position of the cervix under the guidance of the triad diagnosis. Use a probe or a fine cotton swab to probe the cervix, and then use a neck brush to take a sample. You can also use an HPV sampler to take a deep sample of the cervix.

  Proper sampling method

  (1) Cervical brush is the most skillful. First, swab the mucus covering the outer cervix with a cotton swab. If it is difficult to remove the mucous plug from the cervix in the middle of menstruation, use oval forceps to remove it. Do not wipe it forcefully to avoid bleeding from the epithelium. Extend the longer bristles of the cervix brush into the cervical canal and rotate clockwise 5 times, then rinse the cervix in the preservation solution for at least 10 seconds, press against the bottom of the bottle, press firmly, and then rinse for 10 seconds.

  For severe old lacerations or changes in cervical hypertrophy, valgus, or severe "erosion", in addition to the sample in the center area, the edge of the valgus should also be brushed, that is, the red color at the junction of scales and columns. To the pink transition zone. Use the sampling brush to take a sample on the edge of the laceration or the transformation area on the periphery of the "erosion" surface, sweep it gently, and then take the cells close to the cervical canal or "erosion" surface.

  (2) When using the cell brush or HPV sampling brush, in order to reduce bleeding, it is more appropriate to rotate the cell brush or sampling brush 1/4 circle (90 degrees) to half a circle (180 degrees). In order to collect as many specimens as possible, it can be combined with a scraper. Place the scraper directly on the cervix and rotate it for at least 1 week, and quickly shake it in the preservation solution for at least 10 seconds, and then use the cell brush or HPV sampling brush to collect the cells in the cervical canal.

  (3) When encountering excessive vaginal discharge, large cervical canal, and suspected adenocarcinoma in clinical practice, attention should be paid to cervical canal sampling, and the cell brush should be inserted into the cervical canal to sample. There is also a unique trick to increase the amount of cervical canal cells for examination: insert the HPV sampling brush head into the cervical canal, rotate it one turn, then take the brush head out and rinse it in a small bottle with preservation solution. When there are still secretions on the brush head, take a piece of paper towel (must be a paper towel, none of the other types will work), wipe the brush head until all the secretions are wiped off, and finally remove the paper with the secretions Tear them off and put them in a vial together for inspection.

  The right sampling time

  1. Clean menstruation within 3 to 4 days, the best time is the second half of the menstrual cycle, because at this time, there is less shedding of endometrial cells and less interference with cervical cytology.

  2. When the cervix and vagina are severely inflamed, samples cannot be taken and anti-inflammatory treatment is required.

  3. Sampling should not be taken during the menstrual period, and caution should be taken during pregnancy.

  Fourth, sampling cannot be repeated within a short period of time, and sampling shall be repeated after at least 2 months.

  Sampling considerations

  (1) Sexual life is prohibited within 24 hours before sampling, and vaginal washing and medication are not allowed for at least 48 hours;

  (2) Lubricants cannot be used when the speculum is inserted into the vagina;

  (3) Use moderate force when sampling to avoid bleeding. If the bleeding is too much, stop it. Use a dry cotton ball (or cotton swab) to stop the bleeding before taking it;

  (4) In perimenopausal and postmenopausal women, pay attention to cervical canal sampling.

  Successful sampling can not only effectively screen cervical diseases, but also reduce the patient's repeated examination rate. Learning how to standardize sampling is a key link to improve screening results.

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24-hour service hotline:13507170818 

Service Hotline (TEL):86-0712-2369936   

Contact QQ (working hours): 847453892

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