What does the atrophic type of smear mean? What is an atrophic type of smear in gynecology?

Cytology smear

A smear for vaginal cytology in gynecology is prescribed to identify any deviations and anomalies in the cells of the cervix.

Using this study, the cellular structure of the uterus and the ratio of healthy cells to atypical cells are assessed.

A smear allows you to diagnose cell changes in the early stages of development. Timely detection of atypical cells makes it possible to prevent serious diseases or treat them in the early stages.

A smear for cytology is prescribed to all women who are sexually active at least once a year.

The gynecologist should perform a smear during a routine examination or advise the patient about a more favorable time for the test.

Pathologies of cervical cells develop over a fairly long period of time. That is why, for preventive purposes, cytology smears are not prescribed so often. In some cases, an exception is made and the analysis is repeated.

First of all, an additional smear for cytology is taken when planning pregnancy.

The doctor prescribes this study along with other tests in order to most accurately determine the health status of the expectant mother.

It is important to note that during pregnancy a smear for cytology is not used, and the planned examination is postponed to the postpartum period.

Cytology examination is also carried out in case of any gynecological diseases.

The analysis is prescribed for infertility, menstrual irregularities, and certain types of gynecological infections.

Human papillomavirus and genital herpes are especially dangerous for normal cellular structure.

If the patient has such diseases, then a cytology study is mandatory.

A risk factor for the development of cell pathologies is a large number of sexual partners in women.

The danger is unprotected sex, which puts the uterus at risk of infection.

Therefore, women who are at risk are prescribed a smear for cytology more than once a year.

A study of the condition of the cells is carried out before installing an intrauterine device and in the case of prescribing hormonal contraceptives.

This type of smear is recommended for obese women more often than usual.

READ The appearance of mucus in the smear

Classification of estrogen smears

Doctors distinguish several types of estrogen smears, each of which will characterize its owner in its own way.

The first type of smear determines severe estrogen deficiency. Cells of the basal layer predominate, but there are also single large leukocytes in the smear.
The second type is observed with moderate estrogen deficiency. In such a smear, parabasal cells with large nuclei will predominate. Single cells of the basal layer and intermediate layer, as well as single leukocytes, may be encountered.
Slight estrogen deficiency is observed when intermediate epithelium is detected with preservation of surface epithelial particles. This is what the third type of smear looks like.
If the body is well saturated with estrogen, doctors diagnose the fourth type of smear - it is dominated by surface epithelial cells with fairly small nuclei, the shape of most cells is correct. Thus, if a woman has such a smear result, doctors draw a conclusion either about increased estrogen production or about progesterone deficiency. A definitive diagnosis can be made after obtaining a blood test for hormones.

Procedure and preparation for the study

For an informative and accurate result, you must follow all the doctor’s recommendations for preparing for the analysis. The timing of the study is of great importance.

The doctor chooses a specific day for taking a smear depending on the schedule of menstruation and ovulation.

There is an opinion that it is best to do the analysis a few days after your period. However, the acceptable time frame for sample collection may be longer.

It is best to choose a specific day for a smear together with a gynecologist, in accordance with the menstrual schedule of a particular woman.

To accurately navigate the date of menstruation and the timing of ovulation, it is useful to use special calendars, which can often be obtained from a antenatal clinic.

In addition, it is possible to use special computer programs and mobile applications that allow you to record not only the dates of menstruation, but also track the symptoms and complaints of a woman on each specific day of the cycle, and mark the dates of sexual intercourse. In this case, you can set the optimal time for a smear.

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A smear is performed during an examination in a gynecological chair. To take a sample, which is taken from a specific area of the uterus, the doctor uses a sterile phytobrush.

The doctor must obtain cervical cells located under the first layer of the epithelium, since the cells of such a layer do not allow for an informative study.

This type of smear is not performed during inflammation, as it can lead to the spread of infection and complication of the disease.

In the case of itching and unusual vaginal discharge, the nature of which is unknown, such research will have to be abandoned until the cause of the unpleasant symptoms is clarified.

A few days before the analysis, the patient should refrain from any sexual intercourse, the use of vaginal suppositories, creams and gels.

A week before the test, you should not douche. Before the analysis, at least two hours must pass from the last urination.

This type of smear procedure is virtually painless and takes only a few seconds. In some cases, slight bleeding may appear after the examination.

Therefore, women are advised to carry panty liners with them. Preservation of spotting is acceptable for 1-2 days after the smear.

In case of heavy or prolonged bleeding that is not associated with menstruation, you should seek help and report that it was caused by scraping.

READ Diagnosis of diseases using epithelial smear testing

Analysis results are prepared within 24 hours. If necessary, the doctor may prescribe a repeat examination for the patient.

Presence of atrophy in the smear

The most popular question about the atrophic type of smear is “what does it mean”? An atrophic smear occurs with certain disorders of the vaginal and uterine mucosa.

Atrophy is a change in the mucosa, which is caused by a decrease in estrogen levels.

Often the prerequisite for the pathology, which results in an atrophic smear, is menopause or artificial menopause.

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Atrophy can manifest itself in dryness of the vaginal mucosa, decreased secretion of vaginal lubrication, and increased acidity of the organ environment.

This type of smear is often accompanied by a violation of the microflora of the genital organs. The number of lactobacilli decreases, and the percentage of pathogenic flora increases.

Patients may complain of burning sensations and itching. A specific sign accompanying an atrophic smear may be loss of pubic hair.

An atrophic smear may indicate a gynecological disease such as vaginitis.

This disorder is not a temporary failure, but a morphological change in the structure of the cells of the uterus and vagina. Therefore, various types of research are used to diagnose the disease.

Some signs of atrophy can be revealed by a simple gynecological examination. The doctor will make preliminary conclusions by visually observing the cervix using a speculum.

If necessary, an ultrasound examination of the pelvic organs may be prescribed.

A smear for microflora, a study of the acidic environment of the vaginal contents, and, in particular, a smear for cytology are informative.

Atrophy can occur both for natural reasons (for example, menopause) and in the case of malignant cell changes.

Therefore, if an atrophic type of smear is detected, the doctor should prescribe the patient a comprehensive examination of the uterus.

The cause of an atrophic smear may be insufficient blood flow to the pelvic organs. The risk of atrophy increases with smoking.

In older women, vaginitis and atrophy can develop against the background of natural hormonal changes.

In many cases, the changes are not associated with any pathologies, but they need to be monitored and the dynamics of the disease progressed.

In some cases, due to a decrease or complete deficiency of estrogen, the disappearance of lactobacilli in the genitals may be observed.

Due to structural changes in the vagina caused by old age, conventional diagnostic methods can be very difficult.

In some cases, it is necessary to perform anesthesia for examination and taking a smear.

READ Throat swab analysis and interpretation

What is cervical atrophy – Gynecology

Atrophic changes in the vulva, vagina and cervix usually appear after the attenuation of ovarian function, mainly in postmenopause. In women of childbearing age, atrophic changes indicate disruption of the activity of the endocrine glands.

Similar phenomena are observed in women with primary infertility, with uterine hypoplasia and ovarian failure, as well as with menstrual irregularities. Humperl believes that atrophy occurs when the cell receives insufficient nutrition. In this case, the cell shrinks, atrophy of the cytoplasm occurs, and the nucleus also decreases.

In addition to decreased nutrition, the cell can atrophy upon reaching a certain age, then they speak of senile atrophy. It is necessary to mention the third possibility of the appearance of atrophy - atrophy of passivity. The fourth possibility is pressure atrophy, which purely mechanically leads to cell damage. This book deals mainly with cases of senile atrophy.

After ovarian function declines, the cells do not mature due to a lack of estrogen. The topmost layer of the shell, the stratum lucidum (cellular layer), may completely disappear. The epithelium, consisting of a layer of basal and spinous cells, becomes thinner, thin blood vessels are visible under it.

Due to insufficient cell maturation, there is not enough glycogen, so the natural protection from the acidic environment of the vagina is lost. Secondary inflammation often occurs (see also section 4.2.3). The atrophic epithelium is easily wounded, and the colposcopic picture shows a wide variety of changes. Along with focal spotty hemorrhages, diffuse bleeding and small erosions can be observed.

Diagnostic difficulties are caused by vessels visible as thin reddish dots. They correspond to the pattern of punctation in atypical epithelium, which, as is known, does not pose a danger. After topical use of preparations containing estrogens, in addition to oral estrogen and anti-inflammatory drugs, such changes quickly resolve.

The results are clearly visible in the photographs during a colposcopic examination.

Atrophic epithelium

Rice. 88. Patient 53 years old. Has two children. He makes no complaints.

The pale red color of the mucous membrane and translucent vessels in the area of the anterior lip of the uterine pharynx indicate thinning of the squamous epithelium.

Similar atrophic changes are found in menopause and postmenopause, when the formation of estrogen gradually ceases. In this patient, the external uterine os shrinks and looks like a pit.

Multiple foci of bleeding during atrophy

Rice.

89. Patient 65 years old. Postmenopausal period. As a result of atrophy, the squamous epithelium has become thinner, so with the slightest pressure, the vessels located under it begin to bleed.

Atrophic epithelium with multiple foci of vascularization

Rice. 90. Patient 70 years old. In the area of the posterior lip of the uterine pharynx, multiple foci of vascularization are visible. They arise due to the vulnerability of thinned squamous epithelium. In the area of the anterior lip of the uterine pharynx there are many petechial foci of bleeding. In addition, a polyp covered with squamous epithelium is visible in the cervical canal.

Atrophic epithelium

Rice. 91 (compare with Fig. 92). A nulliparous woman, 42 years old. Primary infertility. Atrophic squamous epithelium with two small areas in the form of tongues, tender, vinegar-white, located between 2 and 4 o'clock of the conventional dial, indicates insufficiency of hormonal function

Atrophic epithelium
Atrophic squamous epithelium
Atrophic squamous epithelium

Rice. 92 (see Fig. 91). Cervix of the same patient 11 years later. Menopause period. The total follow-up duration was 25 years. The phenomena of atrophy intensified. Small areas of bleeding are visible and do not cause concern. What is striking is the trough-shaped depression in the area of the external pharynx, which is almost indistinguishable. Rice. 93.

A nulliparous woman, 20 years old. Uterine hypoplasia and secondary amenorrhea. The squamous epithelium is slightly atrophic. Around the external pharynx, a slightly oval, delicate vinegar-white epithelium is visible, the border of the remaining squamous epithelium is clearly raised. A similar condition in a young woman indicates a dysfunction of the endocrine glands. Rice.

94.

The patient is 54 years old. Postmenopausal period. Atrophy with foci of vascularization. In the area of the anterior lip of the uterine pharynx, atrophy is in the form of dots, in the region of the posterior lip of the uterine pharynx - flat. After local treatment with estrogen, healing occurred.

doctor online Source: Bauer G.. Color atlas on colposcopy Part 1. 2002

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Atrophic type of smear

Many women get a PAP smear or Pap test from time to time.

This is a study in which a smear is taken from the vagina and cervix for oncocytology.

The diagnostic method is used for screening detection of cancer, as well as precancerous conditions.
During a microscopic examination of the obtained clinical material, a specialist examines the cellular composition of the smear.
From it, he draws conclusions about whether atypical cells are present, whether there are signs of inflammation or atrophy of the epithelium of the genital organs.
Sometimes women, especially in old age, receive an atrophic type of smear.

What does this mean, and how dangerous is this condition?
Let's talk about what an atrophic type of smear is in gynecology.
What is atrophy?
To understand what the atrophic type of smear means, you need to understand what the word “atrophy” itself means.
It is based on the word “trophism”, which means “nutrition”.
Tissues that receive sufficient nutrients from the blood develop normally.
If there is not enough nutrition, they degrade.
The prefix “a” in any medical term means the absence of something.
In our case, atrophy is the lack of trophism, that is, nutrition.
The blood supply to tissues in the genital area is disrupted.
This leads to their degradation.
In fact, the body does this itself.
It saves its resources and reduces the blood supply to those organs that it is not currently using.
Most often, atrophic processes in the vagina occur in old age, when the genitals become “unnecessary”.
After all, their main purpose is conception, gestation and birth of a child.
Most postmenopausal women are not sexually active.
Their estrogen levels are low.
Therefore, the mucous membrane of the genital organs gradually atrophies - it becomes thinner and is no longer able to fully perform its functions.
This condition is considered normal if it occurs in old age and does not require treatment.
With the exception of situations where a woman experiences discomfort due to atrophic processes, or they become the cause of recurring inflammatory diseases of the vagina and cervix.

Atrophic type of smear - what does it mean?

If you have had a smear for oncocytology, the atrophic type of smear may be indicated in the conclusion.
Let's talk about what this means.
The mucous membrane of the genital tract consists of various cells.
They all have different degrees of maturity.
That is, one type of cell gradually turns into another.

All cells are divided into four types:

superficial - large in size, with a small core, separately located, detected in large quantities in the middle of the menstrual cycle;
intermediate - slightly smaller in size, have a large round core, located mainly in layers;
parabasal - small round cells with a large nucleus, normally found only during menstruation, and even then in small quantities (an increase in their number indicates atrophy);
basal - even smaller than parabasal, the nucleus occupies a third of the cytoplasm, appear only after menopause, as well as after childbirth.

Superficial ones are located at the very top, while basal ones are located deep in the mucous membrane.
Superficial ones have the highest degree of maturity, and basal ones have the least.
Thus, if a large number of mature cells enter the smear, this means that they develop normally and tissue trophism is preserved.
If there are many immature cells present in the smear, this indicates atrophic processes.
Atrophy is a relative concept, not an absolute one.
That is, it does not belong to those processes that either exist or do not exist.
There is no clear boundary between normal and intermediate type of smear, intermediate and atrophic.
These changes occur gradually.
There are more and more immature cells, and fewer and fewer mature cells.
The more pronounced the atrophy, the more parabasal cells are contained in the cervical epithelium.
As atrophy develops, the size of their nuclei also increases.

Causes of the atrophic type of cervical smear

If you have an atrophic type of cytology smear, the reasons for this may be different.

The main ones:

age-related decline of reproductive function;
an atrophic type of smear is often observed after childbirth;
estrogen deficiency at a young age;
long-term chronic inflammatory processes (colpitis).

Women of reproductive age may also experience an atrophic type of smear.

This happens when:

dysfunction of the ovaries;
dysregulation of ovarian function with a decrease in estrogen production (this is caused by pathology of other endocrine glands, for example, the hypothalamic-pituitary system).

An atrophic type of smear is possible after removal of the uterus and appendages, for example, in the case of malignant neoplasms.
The ovaries can also be damaged by radiation therapy.
Young women sometimes develop ovarian failure syndrome, characterized by anovulation and hypoestrogenemia.
Resistant ovarian syndrome is possible due to disruption of their receptor apparatus.

In this case, their full work is impossible due to the fact that the ovaries do not perceive “signals” coming from other endocrine glands.

That is, they do not respond to changes in the level of other hormones that should stimulate the formation of estrogen.

Cytogram corresponds to age, atrophic type of smear

With age, the atrophic type of cytology smear becomes the norm.
During menopause, estrogen levels decrease.
This inevitably leads to deterioration of the trophism of the genital organs.
Atrophic processes gradually occur if the woman does not receive replacement therapy.
They progress over the years.
In this case, it is not so much age that is important, but the number of years that have passed since menopause.
Menopause is the date of the last menstrual period.
It is determined retrospectively (that is, in the past).
Because during menstrual bleeding, a woman cannot know that it is her last.

But if 12 months have passed since the last period, this means that they will no longer occur.
The woman then remembers when she had her last menstrual period, and this date is considered the date of menopause.
5 years after the cessation of menstruation, an atrophic type of smear is already detected.
Age-related changes are still weakly expressed.
About 50% of intermediate cells are usually observed in a smear.
This is already an atrophic type of uterine smear, but the atrophy is still weakly expressed.
The appearance of parabasal cells indicates deep atrophy.
Before menopause, normally they should not be in the smear at all.
Even 5 years after menopause, only 17% of women have them.
Their presence indicates pronounced atrophic processes with severe estrogen deficiency.

Source:

Treatment of atrophy of the vaginal mucosa with various means

Vaginal atrophy is a thinning of the vaginal epithelium and is directly related to a decrease in the blood concentration of estrogen produced by the ovarian follicles. This gynecological disorder is one of the most common diseases in older women, but its manifestations are also possible during the reproductive period.

Source: https://cmsch71.ru/ginekologiya/chto-takoe-atrofiya-shejki-matki.html

Age-related cell destruction

There are several types of cells that reflect their development:

Superficially keratinized
- large cells with a small nucleus.
Intermediate
- the overall cell size is smaller.
Parabasal
- the cell size decreases, and the nucleus increases.
Basal cells
are the atrophic type of cells.

Cell atrophy is their almost complete destruction

. They decrease in volume and their functions are impaired. The greater the atrophy, the larger the nucleus of these cells. It occupies almost the entire cytoplasm.

Cause and result

What is the reason for the atrophy of cells taken for cytological analysis from the epithelium of the cervix?

They lack the female hormone estrogen to grow and mature. Estrogen improves blood supply to the vaginal epithelium, promotes the formation of lactic acid and maintains an acidic environment.

It is the acidic environment that favors the proliferation of beneficial lactobacilli - Doderlein bacilli. In the opposite case - as a result of the appearance of cellular denerates in the tissues of the female organs - a proliferation of leukocyte cells and a decrease in protective Doderley bacilli are observed.

The vagina is literally open to infection and subsequent inflammation. Hence the appearance and development of bacterial vaginitis.

Pap smear to determine estrogen levels

It turns out that a cytology smear helps determine not only gynecological problems, but also the general condition of a woman’s body. After all, the level of estrogen affects, for example, the development of osteoporosis. There are 4 levels of the female hormone, each of which tells about the processes in a woman’s body:

Severe deficiency:
only atrophic cells and leukocytes were found in the epithelium.
Moderate deficiency:
the presence of atrophic, intermediate and leukocyte cells.
Moderate deficiency:
the presence of only atrophic and intermediate cells.
Normal estrogen saturation:
only keratinized cells are present.

Hormonal imbalance is typical for older women who entered menopause several years ago.

Moreover, such a phenomenon is considered for granted. If the atrophic type of smear appears in a young woman, then this is a reason to contact the gynecologist again.

Suspicion of cancer

Atrophied cells in their structure resemble parakeratosis.

These are pathological keratinized tissue particles that signal the appearance of neoplasms, possibly malignant. Therefore, this phenomenon is called pseudoparakeratosis. Once you are diagnosed with cancer, get tested again.

Types of Estrogen Response

Such a smear allows you to assess the condition of the uterus and ovaries according to four characteristic types of estrogenic reaction:

with the first type of reaction, there is a clear lack of estrogen and an increased number of leukocytes and atrophic cells;
the second is characterized by a moderate estrogen deficiency, as well as the presence of leukocytes and atrophic cells, but their concentration is less than in the case of the first type;
the third is characterized by an equal ratio of all types of epithelial cells;
with the fourth type, the estrogen content is excessive.

During the premenopausal period, a smear with a slight increase in estrogen content can be considered a variant of the norm, since the reproductive system has not yet lost its reproductive function and the amount of estrogen is synthesized by the ovaries in sufficient quantities, in addition, the influence of changes in the general hormonal background is added. In this matter, it is the quantitative characteristics of the indicators that mean a lot.

As menopausal changes progress, the estrogen type of smear reveals an increased content of dying cells. In this case, there is a significant decrease in the amount of progesterone.

By the time of entry into postmenopause, leukocytes and cells that make up the basal layer are not detected in the smear. This period is characterized by a change in the structure of the cytoplasm (the internal environment of the cell) - its granularity and heterogeneity are observed. This may be a symptom of trouble, for example, indicating the development of inflammation.

The estrogenic type of smear in menopause is more common in women with increased body weight, which is probably explained by the fact that adipose tissue cells are also capable of synthesizing estrogens along with the adrenal glands.

To determine the quantitative ratio of epithelial cells, the karyopyknotic index (KPI) is used, which is calculated by the ratio of the number of surface cells with a pyknotic nucleus (that is, a wrinkled nucleus that has been exposed to a pathological factor) to the total number of all epithelial elements. It is the indicator of the quantitative ratio of elements that helps determine the estrogen saturation of the body. For the menopausal period, the level of the CPI should not be higher than 25%; during postmenopause, its indicators should be within 10-20%.

Features of treatment

If, as a result of the test, an atrophic type of smear is observed, then you definitely shouldn’t despair in advance. This does not provide a 100% guarantee that you are susceptible to cancer. Most often, such a smear is done for general monitoring of the female genitourinary system. Therefore, even if you heard that you have an atrophic type of smear, this is not the main indicator of oncology.

Quite often, women are susceptible to a disease such as atrophic colpitis. It is not very dangerous for women's health, but nevertheless requires immediate treatment.

Most often, this disease is successfully treated with hormonal therapy. For this, special suppositories or ointments are used, which are inserted into the vagina for two weeks. In addition, tablets or patches are used. For best results, this therapy is practiced for six to seven years. Many doctors recommend eating foods rich in phytoestrogens.

The atrophic type of smear, in which the cervix is in a damaged state, can only be cured if complex methods are used. This may include medications prescribed by your doctor, as well as the use of special products.

The atrophic type of smear, the treatment of which should be started immediately, most often manifests itself as atrophic vaginitis. This disease is associated with an incorrect hormonal background of a woman and with an insufficient amount of the hormone estrogen secreted. Very often, vaginitis can be caused by menopause, which can be either natural or artificial.

During natural menopause, the amount of hormones is a normal response of the female body to age. In cases of artificial menopause, an insufficient amount of hormones is a consequence of a disruption in their production by the ovaries. This problem can be solved quite simply using special methods.

What the atrophic type of smear means can only be determined by your attending physician. If your diagnosis is “atrophic vaginitis,” then you definitely shouldn’t be upset. It is treated with very simple and accessible methods. By the way, the harbinger of such a disease are the following symptoms:

– itching and burning in the internal and external genital organs;

– high vaginal dryness;

– very frequent trips to the toilet. In this case, the amount of fluid released does not change;

– bloody discharge from the vagina of unknown nature;

– hair loss on the pubis and labia;

– frequent vaginal bleeding even with the most minor damage.

What is an atrophic type of smear in gynecology?

The atrophic type of smear, like other smears, is considered a cytological examination of the cervix, giving extremely accurate results regarding the diagnosis of cancer and precancerous conditions of the woman’s genitourinary system. Timely and regular submission of smears for cytology reduces the likelihood of developing cancer several times.

The main purpose of these tests is to identify the earliest forms of cancer and treat them in the initial stages.

What is an atrophic type of smear in gynecology?

A cytology smear is one of the most important gynecological examinations. For a gynecologist, this is the easiest and most reliable way to find out what condition the cervix is in.

The atrophic type of smear is a good and reliable way to find out the quantitative ratio of standard and parabasal cells. This analysis makes it possible to get a clear picture of the condition of the cervix, as well as find out the amount of hormones in the ovaries.

Why is this smear used in gynecology?

The atrophic type of smear (you can read what this means in this article) is considered the most reliable method of passing gynecological cytology tests. This method is considered very simple and accessible to all segments of the female population. With its help, you can determine the condition of the cervix and take subsequent therapeutic or preventive actions.

The atrophic type of cytology smear has the main goal of identifying unnatural and foreign cells found in the female body. Usually, in a normal, healthy woman, such cells are absent. Very often, it is these foreign cells that are the beginning of the appearance of malignant tumors.

If the gynecologist informs you that the test result is unsatisfactory, do not delay treatment under any circumstances.

If there are deviations of any type, immediately undergo additional medical tests that will help establish the whole picture. Most often, such examinations help detect cancer in the early stages.

The sooner you start treatment, the more likely it is to be successful.

What is atrophy

Before dealing with the disease itself, you should understand what atrophy is. In gynecology, this concept refers to the predominance of parabasal cells in the body. At the same time, the number of ordinary cells decreases significantly. Most often, a large number of leukocytes will be found in the smear, and the volume of Dederlein bacilli is as low as possible.

In some women, ideally, the same number of these cells can be observed only during menopause. This condition lasts no more than five years. At this time, the amount of estrogen in the female body decreases significantly, but this does not affect the microflora, and it can be in ideal condition.

The atrophic type of cervical smear begins to develop due to a deficiency of the female hormones estrogen. It is worth paying attention to the fact that there are several types of cells contained in the cervix:

– basal;

– intermediate;

– parabasal;

– upper stratum corneum.

In this case, each cell belongs to its own layer of tissue. For example, superficial keratinizing cells are considered the outermost layer of the vaginal epithelium. In front of them are several intermediate layers of epithelial cells.

The lowest layer of epithelial tissue consists of basal cells, which over time begin to transform into other cells located in the intermediate layers.

The female hormones estrogens are responsible for the process of cell transformation. If there are not enough of these hormones in a woman’s body, then the process of cell transformation begins to be disrupted, which is why the main problems appear.

Most often, the atrophic type of cytology smear occurs in more mature women as a result of decreased hormonal levels.

These processes occur as a consequence of decreased performance of the female genital organs. It is no exception that in adulthood this smear may even be considered absolutely normal.

At a younger age, problems arise due to improper functioning of the genitourinary system and problems with hormonal levels.

Features of treatment

Quite often, women are susceptible to a disease such as atrophic colpitis. It is not very dangerous for women's health, but nevertheless requires immediate treatment.

Most often, this disease is successfully treated with hormonal therapy. For this, special suppositories or ointments are used, which are inserted into the vagina for two weeks. In addition, tablets or patches are used. For best results, this therapy is practiced for six to seven years. Many doctors recommend eating foods rich in phytoestrogens.

– itching and burning in the internal and external genital organs;

– high vaginal dryness;

– very frequent trips to the toilet. In this case, the amount of fluid released does not change;

– bloody discharge from the vagina of unknown nature;

– hair loss on the pubis and labia;

– frequent vaginal bleeding even with the most minor damage.

Atrophic type of smear: parakeratosis

Only a gynecologist can diagnose this disease after examination. To effectively treat this disease, it is recommended to restore hormonal levels.

The specialist will select the medications based on your tests. In this case, the hormone estrogen can enter the female body with the help of tablets, suppositories, patches or ointments.

It is also recommended to take vitamins and improve vaginal tone through special exercises.

Parakeratosis is a disease of the cervix, namely the keratinization of its mucous layer. This phenomenon is most often associated with traumatic factors. This may include medical intervention, as well as the formation of infections. Human papillomavirus is also possible.

To treat this disease, the mucous membrane of the cervix is scraped and further studied to determine the presence of foreign cells. Laser cauterization of damaged areas is very often used. Under no circumstances should this disease be treated with traditional methods.

What does a smear look like?

Looking at a smear with the naked eye, it is impossible to understand that there is something wrong with it. After all, outwardly it will be no different from a smear of a young healthy woman.

Therefore, cytological examination (atrophic type of smear) can only be carried out using a modern microscope.

Women should pay attention to the fact that they need to do this every six months to maintain their health and longevity.

The atrophic type of smear (what this means can be read in this article) has the appearance of parabasal cells, which make up the bulk of the total cell mass. Estrogen deficiency leads to the fact that the epithelial tissue in the vagina does not pass into other types of tissue, and this is the main problem.

Scientists also noticed that the more progressive the atrophy, the more the nucleus of the parabasal cells increases. The deepest atrophic stages allow us to notice that the nucleus becomes so large that it can displace all other vital elements of the cell. Despite the fact that the nucleus increases significantly, the cell itself remains the same size.

Products containing estrogens

Estrogens are female hormones responsible for the correct and coordinated functioning of the female genitourinary system. If the body does not have enough of these elements, then not only medications, but also food can come to the rescue.

Estrogens are very important for women's health in general. They are responsible for the beauty and general condition of a woman. Therefore, if your hormones are not enough, you should take phytoestrogens into account.

Scientists have proven that the largest amount of them is found in beer. But you definitely shouldn’t abuse this product. In addition, other foods of plant origin also contain a large amount of estrogens, which are worth paying attention to first.

A very large amount of the much-needed female hormone is found in legumes. Especially in soy. But peas, red beans and other beans are also not inferior to it.

Pay attention to flax seeds, which in addition to hormones also contain large amounts of other beneficial substances. In modern medicine, it is the extract from them that is used as a substitute for natural female hormones.

There are a lot of estrogens in grain crops. Especially in wheat. For a woman, the most optimal breakfast would be porridge, especially with bran.

Don't ignore dairy products. Since the cow that produces milk eats a lot of grass rich in estrogen, the milk will contain a large amount of female hormones.

However, do not forget that moderation is needed in everything. Before starting to take herbal hormones, be sure to consult your doctor. After all, their excess can lead to many diseases, one of which is breast cancer.

Cytology smear

In order to determine the condition of the genitourinary system in gynecology, it is customary to do a cytology smear.

This procedure allows you to find out about the condition of the mucous membrane of the cervix, as well as pay attention to the presence of various pathologies. A cytology smear allows you to carefully examine the epithelial cells.

This method is the most accurate and reliable for determining the composition of the epithelium, because even the slightest changes will be noticeable under a microscope.

Most often, cytological studies are carried out in order to study all kinds of changes in the cervix, as well as in the vaginal mucosa. During this test, several types of smears may be noticed:

– inflammatory:

– estrogenic;

– androgynous;

– regressive or atrophic type of smear (you now know how to treat the pathologies that cause it);

– mixed;

– progesterone.

Each of these types of smears has its own essential characteristics, which are expressed in the predominance of some cells over others. If we talk about an atrophic type smear, then in this case the epithelium is largely dominated by parabasal cells. They will have very large kernels. At the same time, the size of the cell itself remains insignificant.

Determining the condition of the cervix

Along with this, changes occur in the vaginal ecosystem. Dysbiotic processes begin to actively progress, and alkalization of the mucous membranes also occurs.

At the same time, the content of bacteria and infections in the female genital organs increases significantly.

The upper layer of the cervix is epithelial tissue, under which there are subepithelial stroma. They can easily begin to bleed even with the slightest damage.

If during the examination a woman is found to have an atrophic type of smear, then the patient urgently needs to undergo other types of examinations. The sooner this is done, the faster and easier the treatment process will be.

Symptoms of cervical cancer

In order to maintain women's health for many years, you should undergo regular gynecological examinations. After all, it is much easier to prevent a disease than to treat it. An atrophic type of smear with a leukocyte reaction and other ailments of the cervix are problems that require immediate solutions.

Cervical cancer is a malignant tumor that develops in the area of the cervix itself. Most often, this disease is noticed in women after thirty-five years of age. But younger women are also susceptible to this disease.

Most often, cervical cancer is characterized by the following symptoms:

– frequent bleeding after sexual intercourse, between menstruation, after douching, as well as during and after a gynecological examination;

– the menstrual cycle may change, and the bleeding period may also lengthen;

– vaginal discharge becomes permanently bloody;

– the amount of leucorrhoea can increase several times;

– the last stages of cervical cancer can be characterized by the appearance of a very unpleasant odor, as well as the release of thick clots;

– sexual intercourse is accompanied by severe pain;

– very frequent pain in the lower back and abdomen;

– there may be a general malaise of the whole body.

In order not to expose yourself to such a dangerous disease, it is worth visiting a gynecologist every six months and taking the appropriate tests.

You should not have sex at a very young age, since the epithelial tissue of the cervix has not yet fully formed. Watch your diet and lead a healthy lifestyle.

Try not to use oral contraceptive methods, because they affect the body's hormonal levels.

Source: https://FB.ru/article/285654/chto-takoe-atroficheskiy-tip-mazka-v-ginekologii

How to take a smear for cervical cytology

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 stratified squamous epithelium of the cervix

Structures of multilayered squamous epithelium of the vaginal mucosa

A - basal layer (a - basal cells, b - parabasal cells) B - intermediate layer, C - superficial 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.

Smear cytology

Under the influence of decreased hormone levels, the ovaries are the first to suffer. Following the fading of their function, the vaginal mucosa begins to undergo changes. Changes in the genital organs do not occur immediately, since some of the functions are transferred to other endocrine glands. In particular, during menopause, the adrenal glands support a function similar to that of the ovaries. This allows a woman to feel menopausal changes less sharply.

That is why smear cytology in menopause at the initial stage shows cells of dead epithelium, still maturing due to the activity of the adrenal glands.

When estrogen levels decrease, cells from the deep layers of epithelial tissue first appear in the smear. The shape of the epithelial cells themselves also changes - their size decreases, they acquire an atypical shape, become more elongated, and sometimes just bizarre.

In a smear, epithelial cells are located either singly or in clusters. Single cells retain their clear boundaries, while cells clustered in groups lose their smooth lines.

The nuclei of epithelial cells become much larger, the membrane becomes clearly visible, and chromatin is noticeable. At the same time, the nucleolus of the epithelial cell cannot be identified. Epithelial cells acquire different colors, despite their uniformity.

In epithelial cells, you can notice an increased content of keratin - it is this protein that gives the cells elasticity. However, with an increase in keratin content, the cells become more coarse and keratinized.

Since insufficient estrogen is produced during menopause, epithelial cells do not mature completely. Thus, they cannot fully perform the function of surface cells, including protective ones.

To protect the vagina from various damages and infections, the body in menopause begins to secrete histiocytes and leukocytes in significant quantities, which take over these functions.

In some cases, when a significant number of leukocytes are detected, doctors diagnose atrophic colpitis. Indeed, leukocytes and histiocytes are markers of inflammation, and such a diagnosis is to some extent justified. However, the nature of atrophic colpitis is somewhat different: if ordinary colpitis is caused by pathogenic microorganisms and requires the prescription of antibacterial drugs, then atrophic colpitis does not need such treatment, because this is a natural reaction of a woman’s body to the aging processes that occur in her. In this case, you should not direct all your efforts to stop the inflammatory process, which is not such.

Which doctor treats cytolytic vaginosis?

If you suspect that you have such a problem, then you should not hope that it will go away on its own. Only a highly qualified specialist can overcome cytolytic vaginosis. Women experiencing such unpleasant symptoms should seek advice from a doctor such as:

gynecologist

The doctor will listen carefully to the patient at the first appointment. He will also conduct a gynecological examination, making sure that the disease has not caused inflammation in the patient’s genitals. To draw up a complete clinical picture of the disease, the doctor will definitely ask the woman several questions:

Is her menstrual cycle regular?
Is she sexually active?
Are there any other health complaints?
Did she have any sexually transmitted diseases?
How long ago did the first symptoms of cytolytic vaginosis appear?
Has she had problems like this before?
Do you suffer from chronic diseases?

The doctor will also ask if the woman is taking any medications. He will also clarify the presence of allergies to drugs. The survey helps the doctor make the correct diagnosis. Also, the information received from the patient will be used by the doctor when developing a treatment program.

How does a woman find out about dysbiosis?

Symptoms of dysbiosis are:

The appearance of white cheesy discharge;
The appearance of a burning sensation and itching.

A woman may think she has thrush. Most often this is what happens. Even doctors can make such a diagnosis based only on external changes. But upon deeper analysis, the microscopic picture shows that the smear is clean, there is no fungus in it, which means there is no thrush. But it also happens that lactobacilli and the causative agent of thrush can coexist more or less normally, and these pathologies may well be combined.

Diagnosis of vaginal microflora dysbiosis

Any effective treatment begins with a correct diagnosis. It is established from the information provided by a cytogram of bacterial vaginosis as a result of a microscopic examination of the vaginal contents and laboratory test data.

Signs of dysbiosis

Normal leukocyte formula (in the field of view of the microscope no more than 10);
Acidity below pH 3.5;
Deformed free-lying cell nuclei;
Cytolysis of the epithelium;
The key “false” cells are mostly lactobacilli that end up on the outer membrane of the vaginal epithelial cells.

Determining the condition of the cervix

The female genitourinary system can work perfectly only if the ovaries produce a sufficient amount of hormones - estrogens. In case of their deficiency, the condition of the cervix may not change for the better. Along with this, changes occur in the vaginal ecosystem. Dysbiotic processes begin to actively progress, and alkalization of the mucous membranes also occurs. At the same time, the content of bacteria and infections in the female genital organs increases significantly.

The upper layer of the cervix is epithelial tissue, under which there are subepithelial stroma. They can easily begin to bleed even with the slightest damage.

What is an estrogen smear?

Among gynecologists there is a stable expression estrogen smear. Is it good or bad when a woman has just such a smear?

Not all representatives of the fair sex have an estrogen smear during menopause. The essence of such a smear is that the number of cells of the surface epithelium, which performs the main protective function of the vagina, practically does not change. This means that the level of estrogen in a woman’s body is so high that it allows this type of smear to appear.

The reason for the estrogenic type of smear is the body’s ability to compensate for the lack of sex hormones and primarily estrogen. Also, an estrogen smear may appear when a woman receives treatment aimed at maintaining hormonal balance. Hormone replacement therapy helps to maintain normal vital parameters, so the smear will be “like a young person.”

However, such indicators do not always please doctors, who, based on objective indicators, see that the woman is approaching menopause.

In some cases, maintaining high estrogen, and therefore ensuring an estrogen smear, can be a consequence of malignant processes localized in the uterus or ovaries.

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 are chronic. – Menstrual irregularities. – 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.

Causes of inflammatory type of smear (ITM)

Infections and fungal diseases:
candidiasis;
chlamydia;
actinomycosis;
genital herpes;
HPV.
Atrophic vaginitis.
Radiation therapy (radiation damage).
Pregnancy.
Impact of certain medications.
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 (a woman undergoes a smear for oncocytology once every 6 months) or is advised to remove it after a biopsy - with nitrogen, radio waves, electric current or another method. You can read everything regarding 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.

It is not known to this day why lactobacilli suddenly begin to multiply intensively. But a fairly reliable relationship has been established between the disease and higher glycogen levels in the luteal phase of menstruation. Glycogen, as is known, serves as a nutrient medium for lactic acid bacteria. Currently, cytolytic vaginosis has increasingly become a concern for the fairer sex. And the reasons are different.

The exact causes and mechanisms leading to a significant proliferation of normal vaginal lactoflora with subsequent fragmentation and (or) cytolysis of the vaginal epithelium are still unknown. The only reliable connection was identified only between the development of cytolytic vaginosis in the luteal phase of the menstrual cycle and is apparently associated with an increase in vaginal glycogen, which serves as a nutritional substrate for lactobacilli. Sometimes the phenomenon of cytolytic vaginosis is observed with long-term use of vaginal suppositories containing lactobacilli.

Products containing estrogens

A very large amount of the much-needed female hormone is found in legumes. Especially in soy. But peas, red beans and other beans are also not inferior to it.

There are a lot of estrogens in grain crops. Especially in wheat. For a woman, the most optimal breakfast would be porridge, especially with bran.

Don't ignore dairy products. Since the cow that produces milk eats a lot of grass rich in estrogen, the milk will contain a large amount of female hormones.

Why is this smear used in gynecology?

If the gynecologist informs you that the test result is unsatisfactory, do not delay treatment under any circumstances. If there are deviations of any type, immediately undergo additional medical tests that will help establish the whole picture. Most often, such examinations help detect cancer in the early stages. The sooner you start treatment, the more likely it is to be successful.

Correction methods

If a cytology smear determines the atrophic type, then the issue of treatment is decided.

Women undergoing menopause are prescribed hormone replacement therapy to improve their well-being. The goal is to restore the integrity of the epithelial layer.

For symptomatic treatment, the following drugs are used:

If a woman of reproductive age is faced with atrophy of the vaginal and cervical mucosa, she is prescribed individual treatment.

Antibiotics are usually not used for correction. The exception is when mucosal atrophy is accompanied by an excessive increase in leukocytes, and an infectious pathogen is also detected.

Hormone therapy, which involves restoring the natural functioning of the gonads, becomes the basis of drug treatment.

Physiotherapy and complex vitamin intake are also prescribed.

Patients with a regressive type of cytological smear should reconsider their diet and introduce foods rich in phytoestrogens into the diet: lentils, barley, rice, oats, soybeans, carrots, apples, pomegranates, beer, bourbon.

Alternative medicine suggests using decoctions of red clover, sage and licorice.

Atrophic type of smear: parakeratosis

Only a gynecologist can diagnose this disease after examination. To effectively treat this disease, it is recommended to restore hormonal levels. The specialist will select the medications based on your tests. In this case, the hormone estrogen can enter the female body with the help of tablets, suppositories, patches or ointments. It is also recommended to take vitamins and improve vaginal tone through special exercises.

Parakeratosis is a disease of the cervix, namely the keratinization of its mucous layer. This phenomenon is most often associated with traumatic factors. This may include medical intervention, as well as the formation of infections. Human papillomavirus is also possible.

Interpretation of a cytological examination of a cervical smear

The cervix of a healthy woman is 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 state 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 examined 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 (they are much more than normal). In this case, the initial stage of cancer is diagnosed.

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.

To describe the results of an analysis of a smear containing atypical cells, the following abbreviations are used:
– 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 some 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 a precancerous pathology or an incipient oncological process.
– HSIL
is oncocytological (modified squamous cells present).
Such patients are given immediate treatment to prevent degeneration into a malignant tumor. – AIS
– 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.

Flat epithelium with atrophic changes

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

A cytology smear primarily performed 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 in cells. To determine the infectious agent that caused the inflammation, it is better to use a smear on the flora 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 makes it possible to differentiate different types of epithelium and distinguish between 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.

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.

Source: https://BoliGolovnie.ru/varikoz/ploskij-jepitelij-s-atroficheskimi-izmenenijami.html