A new method for detecting cervical cancer - the liquid-based cytology (LBC)

A new method for detecting cervical cancer - the liquid-based cytology (LBC)

mgr Joanna Kowalczyk-Nowakowska
Department of Gynaecology-Obstetrics Didactics
at the WNoZ
MedicalUniversity of Warsaw

WHAT IS CYTOLOGY?

Cervical cytology, commonly referred to as cytology, is a screening procedure for detecting cervical abnormalities. The cells collected from this site are evaluated under a microscope, which makes it possible to determine if there are any changes in their structure. Cytological smears (cytosmears) are the basic preventive and diagnostic measures against cervical cancer because they make it possible to diagnose the lesions responsible for this disease as well as the different stages of cancer. It is worth remembering that detecting the cancer at its early stage makes it entirely curable. Therefore, cytological examinations can save your life!

LIQUID-BASED CYTOLOGY (LBC)

Liquid-based cytology (LBC)is a cytological technique that has been recently superseding the commonly-known, conventional cytology. It is also known as thin-layer or monolayer cytology. The difference lies in the fact that the collected material is not transferred directly onto a microscope slide, as in the case of conventional cytology (the PAP method), but placed into a special liquid base.  Once protected in this way, it is further processed in the lab before it is evaluated under a microscope. Thanks to the delamination of the smear, it is possible to clear it of mucus, blood and other cells that hinder the evaluation of the epidermis. A thin layer of the material is collected from the cleared suspension and placed onto a slide (which is electronically monitored to make all preparations identical). The cells are concentrated within a small area, which makes it easy to view and evaluate them.

The above method for preparing the material for examination guarantees high quality and reliable results, because it eliminates the illegibility of the image due to such factors as:

  • overlapping cell layers;
  • contamination of the sample;
  • drying out of the preparation;
  • collecting too little cells.

Moreover, by placing the smear in a liquid, the risk of its damage during transportation is minimised.

The great advantage of LBC is the possibility to extend the diagnostics by using the same sample for other tests, which are intended to detect, amongst others, human papilloma virus (HPV), Chlamydia trachomatis bacteria or herpes simplex viruses (HSV).

WHO COLLECTS A CYTOLOGY SAMPLE?

Liquid-based cytology is performed by a gynaecologist during a consultation appointment or an obstetrician at the Damian Medical Center at ul. Wałbrzyska 46 and ul. Komisji Edukacji Narodowej 85. The material is interpreted at dr. Jarosław Wejman’s Laboratory of the Pathomorphologic Diagnostics Centre, which is able to process preparations using the LBC method by means of the SurePath technology by the American Becton-Dickinson company. This technology has received attention in the latest issue of “The Bethesda System for Reporting Cervical Cytology” – the most important handbook on cervical cytology, establishing the standards for cytological reports.

The SurePath technology provides us with a 13 mm field of vision that is subject to cytological evaluation. Not only does it ensure greater comfort of work for cytomorphologists but it also considerably decreases the percentage of non-diagnostic examinations compared to the traditional PAP-based smears.

PREPARATION BEFORE THE EXAMINATION

The results of the examination are available after 14 working days at the centre in which the cytology has been taken.

Moreover, before the examination, patients are required to wash the outer parts of the genital organs and the crotch using an acidic intimate hygiene gel; intravaginal irrigation should not be used before the examination. If the patient is on intravaginal drugs, the examination must be performed not earlier than 6 days after the therapy has been completed.

Substantive consultation:
Professor Ewa Dmoch-Gajzlerska
Jarosław Wejman MD PhD
Centrum Diagnostyki Patomorfologicznej

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