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Cervical biopsy: preparation, types, interpretation of analysis

Processes that violate the integrity of the cervical mucosa, over time, can acquire a pathological course. For a long time, erosion may have no symptoms. A woman finds out about her only after visiting a gynecologist, who, during a mirror examination, assesses the state of the mucous membranes of the reproductive organs.

It is unlikely that erosion can heal on its own. As a rule, physicians use certain types of treatment that help eliminate the displacement of the cylindrical epithelium lining the cervix:

  • Treatment with candles, tampons soaked in medicinal solution, douching.
  • Elimination of the damaged mucosa by surgery using electrosurgery, cryosurgery, laser surgery, radio wave surgery.

But, before proceeding with the treatment, the doctor must take a biopsy, which involves taking tissue from the damaged surface for histological examination of the material for the detection of malignant cells.

What it is? A cervical biopsy is the only method that can be used to accurately diagnose the degree of malignancy of pathological changes that may be present even when the tumor is not visually detected.

Content

Preparing for a biopsy

Cervical biopsy

Since the procedure involves the removal of tissue from the affected area of ​​the external osmosis of the cervix, these manipulations will result in small wounds on the surface of the cervical canal.

In order to prevent the onset of the development of inflammatory processes in the field of material collection for histological examination, the doctor will prescribe a number of additional tests before cervical biopsy.

  • Smear on the flora . It is taken from the vagina and determines the presence of pathogenic microorganisms that may be the causative agents of gonorrhea , chlamydia or syphilis . In addition, the analysis shows the concentration of leukocytes.
  • Blood test for STDs. Results are evaluated together with a smear on the pathogenic flora of the vagina.

Preliminary examination of the cervix

A biopsy of the cervix, carried out during erosion, involves a preliminary study of the surface of the external pharynx with the help of a special optical device - a colposcope. It allows the gynecologist to examine the affected area with a multiple increase and to determine whether there are signs of malignant changes in the mucosa.

The study procedure is called colposcopy. Currently, no biopsy is performed in Russian clinics without prior colposcopy.

A detailed examination of the cervix can also be considered a preparation for the collection of material for histological examination, but in some medical institutions it is common to take a biopsy during colposcopy, and in others - a biopsy is scheduled for another day. But at the same time there should always be a strict sequence: first, examination with a colposcope, and only then - sampling of tissues for analysis.

Types of colposcopy

  • Simple colposcopy - is carried out without the use of special solutions for the treatment of the cervix. With it, the color of the mucous is determined, its relief, the size of the external pharynx.
  • Extended colposcopy - is carried out using special solutions and together with additional tests that are aimed at identifying pathological changes in the structure of the external os.

Technique for cervical biopsy

Technique for cervical biopsy

Despite the existence of several types of biopsy, the method of its implementation in all cases is about the same.

  1. The cervix is ​​treated with a solution of iodine using a cotton pad, which either stains it uniformly or helps to reveal foci of localization of pathological changes in the structure of the mucous membrane.
  2. Gynecological mirrors are inserted into the vagina, the doctor performs an examination of the external pharynx of the cervix.
  3. Bullet forceps are inserted with which the cervix is ​​fixed. Then the neck is lowered towards the entrance to the vagina.
  4. Using the devices, the doctor plucks a piece of cloth from the surface of the cervix. Moreover, if staining with iodine revealed the presence of foci of pathologically changed mucous structures, the material should be taken from the border area between the affected area and healthy tissues. If there are several such lesions, a biopsy is taken from everyone.
  5. The cut-off material is placed in a formalin solution and sent for histological examination.
  6. A cotton swab is applied to the wound to eliminate minor bleeding. Stitching on the surface of the cervix is ​​not required.

During a biopsy, a woman may experience painful and nagging sensations in the lower abdomen. But they are insignificant and short-lived, so anesthesia is not provided. In the next few hours, a sore pain in the lower abdomen may be felt, but it does not require the administration of analgesics. Monthly after biopsy should come on time, in the usual amount.

Biopsy Types

Gynecologists carry out tissue sampling in various ways. The choice of a specific type of biopsy depends on the state of the cervix and whether there is a diseased epithelium on its surface.

Colposcopic biopsy - is performed during colposcopy, if the tests show the presence of lesions on the mucous membrane of the cervical canal, which are at risk of becoming (or have already become) malignant.

The tissue is taken with a biopsy needle. However, if it is necessary to take an analysis from the border area of ​​the epithelium, so that healthy and pathologically altered cells are also in the field of study, this is difficult to do with a biopsy needle.

Conchotomy biopsy is one of the most popular types of cervical biopsy. A piece of tissue from the external pharynx is pinch off with the help of a conchotome, a tool that represents scissors bent at a right angle with forceps at the ends.

Konchotomic biopsy allows you to take an analysis from the border of a healthy and pathologically modified part of the cervical mucosa. When pinching a piece of tissue, the patient feels short-term pain, and a few drops of bleeding may appear during the day.

Radio wave biopsy - involves the use of a radio wave knife to cut off a section of the mucous membrane of the cervix. It is considered a sparing type of biopsy, after which there is no scarring, there are no bleeding and there is almost no pain during the procedure.

Loop biopsy - involves the use of a tool with a loop. A current is passed through it - it helps to peel off the epithelium areas, causing the gynecologist to be suspicious during a visual examination. This method is not recommended for women who are going to have a baby in the future, as scars remain on the cervix after it.

There is also a division of biopsy into several types of localization of tissue sampling for analysis:

  • Endocervical biopsy - scraping cervical fluid from the cervix. For manipulation using a special tool - curette.
  • Cervical conization is a type of biopsy, in which a rather large area of ​​tissue is cut for more detailed histological examination. It is performed in cases when the gynecologist finds well-distinguishable pathologies on the mucous membrane of the cervix uteri. Conization is carried out in a hospital and involves the use of anesthesia.
  • Trepanobiopsy - involves the collection of several pieces of epithelium from different places of the cervix. As a rule, it is used for multiple foci of pathologically changed tissues.

Interpretation of biopsy results

Interpretation of biopsy results

The cut-off piece of tissue is placed in formalin and sent to the laboratory for histology. After 2-3 weeks, a medical report will be ready, which, as a rule, contains many terms that are not understood by ordinary women.

Abbreviations

  • ASC-US - atypical cells of unknown origin, found in squamous epithelium.
  • ASC-H - atypical cells with a high probability of precancerous changes, found in squamous epithelium
  • AGC - atypical cells found in the cylindrical epithelium.
  • LSIL - atypical cells of unknown origin.
  • HSIL - precancerous changes in the structure of the squamous epithelium of the cervix.
  • AIS - precancerous changes in the structure of the cylindrical epithelium of the mucous membrane of the cervical canal.

Terminology

  • Adenomatosis is a precancerous condition of the mucous membrane of the cervix. It happens as diffuse, when atypical changes in the structure of the endometrium spread over the entire surface of the cervix, and focal, when pathologically changed tissue can be found only in certain parts of the organ.
  • Acantosis is a thickening of the epidermis layer. Not considered cancer or precancer. Most often it is benign, only in some cases, the growth of the epidermis becomes a cancer.
  • Dysplasia - pathological changes in the cervical epithelium, which are considered a precancerous condition. It has 3 degrees: CIN 1 (weak), CIN 2 (medium), CIN 3 (heavy).
  • Carcinoma is a malignant disease of the cervix. In the advanced stage, removal of the uterus and cervical canal is indicated.
  • Coilocytes are cells whose presence is a sign of human papillomavirus (HPV). When they are detected, it is necessary to pass an analysis to determine the type of HPV.
  • Microcarcenoma is a malignant disease of the cervix of small invasion (up to 3 mm). Quite well treatable.
  • Leukoplakia (Hyperkeratosis) is an excessively high rate of horn cell division. As a result, cervical horniness is noted during the study. There are two types: simple, not dangerous, and proliferative, which is a precancerous condition that has a greater tendency to take a malignant character.
  • Parakeratosis - excessive keratinization of the mucous surface of the cervix. It is considered a precancerous condition. They are classified because of the occurrence and in the form of the manifestation of pathological changes.
  • Squamous metaplasia is the replacement of a single-layered cylindrical epithelium by a multi-layered one. It is considered a precancerous condition. It provokes the appearance of foci of dysplasia.
  • Cervicitis - inflammation of the cervical canal. May be acute and chronic.

The results of cervical biopsy should not be deciphered by yourself. It is necessary to show them to the gynecologist, who will be able to correctly assess the state of health of the reproductive system, relying not only on the data obtained from the laboratory, but also on the results of colposcopy.

Discharge after cervical biopsy

Discharge after cervical biopsy Since gynecological manipulation involves the collection of a piece of tissue, a wound surface forms on the cervix. The extent and nature of the discharge after a biopsy will depend on the type of intervention. The more traumatic the biopsy was, the more blood can be seen on the daily pads.

Normally, the effects of taking material from the surface of the cervix should not lead to bleeding. If the doctor used a biopsy needle or carried out the procedure using the radio wave method, then the spotting may be absent.

In other cases (except conization), the discharge appears as a few drops of blood or a short yellow-brown daub, which gradually turns into yellow discharge, and then disappears completely.

Contraindications to biopsy

  • Infectious respiratory diseases with fever.
  • Urogenital infections in acute form.
  • The presence of menstruation.
  • The presence of pregnancy at any time.
  • Bad blood clotting.
  • With caution in hepatitis B and C and HIV

Biopsy is the only way to reliably determine at what stage the pathological changes in the cervical epithelium are found. Despite the soreness of the procedure, neglecting it is dangerous for health - especially in cases where the doctor strongly recommended its implementation.

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