The cytological specimens collected from FGT include cervical smear, v

1.	The cytological specimens collected from FGT include cervical smear, vaginal smear, aspiration from posterior fornix of vagina (vaginal pool smear) and endometrial smear. Cervical smear: Cancer of the uterine cervix is the commonest cancer in the FGT. Almost all invasive cancers of the cervix are preceded by a phase of preinvasive disease, which demonstrates microscopically a continuing spectrum of events progressing from cervical intraepithelial neoplasia (CIN) grade I to III including carcinoma in-situ before progressing to squamous cell carcinoma. This progressive course takes about 10 to 20 years. Early detection even at the preinvasive stage is possible by doing cervical smear (Pap Smear Test). This can identify patients who are likely to develop cancer and appropriate interventions may be carried out. (a) What are the advantages of Pap Smear? (b) How the Endo-cervical brush can be used to obtain the sample?
Answer» (a) Advantages of Pap Smear: • It is painless and simple • Does not cause bleeding • Does not need anesthesia • Can detect cancer and precancer • Can identify non-specific and specific inflammations • Can be carried out as an outpatient procedure (b) Endo-cervical brush is a small bottlebrush like device with one end having fine bristles made up of nylons. This device is strictly for taking materials from endocervix. Gently insert the brush in endocervix and rotate one turn pressing in the upper and lower wall. The cytobrush is similar to that of endocervical brush except that the projected tip is without bristles. This can be used for obtaining cells from the whole cervix. Single sampling devices and methods have their limitations in obtaining adequate smears from the cervix. A combination of two devices, usually spatula and endocervical brush, give better results. Triple smear or the vaginal-cervical-endocervical (VCE) technique can provide the best results.

The cytological specimens collected from FGT include cervical smear, vaginal smear, aspiration from posterior fornix of vagina (vaginal pool smear) and endometrial smear. Cervical smear: Cancer of the uterine cervix is the commonest cancer in the FGT. Almost all invasive cancers of the cervix are preceded by a phase of preinvasive disease, which demonstrates microscopically a continuing spectrum of events progressing from cervical intraepithelial neoplasia (CIN) grade I to III including carcinoma in-situ before progressing to squamous cell carcinoma. This progressive course takes about 10 to 20 years. Early detection even at the preinvasive stage is possible by doing cervical smear (Pap Smear Test). This can identify patients who are likely to develop cancer and appropriate interventions may be carried out. (a) What are the advantages of Pap Smear? (b) How the Endo-cervical brush can be used to obtain the sample?

Answer»

(a) Advantages of Pap Smear:

• It is painless and simple

• Does not cause bleeding

• Does not need anesthesia

• Can detect cancer and precancer

• Can identify non-specific and specific inflammations

• Can be carried out as an outpatient procedure

(b) Endo-cervical brush is a small bottlebrush like device with one end having fine bristles made up of nylons. This device is strictly for taking materials from endocervix. Gently insert the brush in endocervix and rotate one turn pressing in the upper and lower wall. The cytobrush is similar to that of endocervical brush except that the projected tip is without bristles. This can be used for obtaining cells from the whole cervix. Single sampling devices and methods have their limitations in obtaining adequate smears from the cervix. A combination of two devices, usually spatula and endocervical brush, give better results. Triple smear or the vaginal-cervical-endocervical (VCE) technique can provide the best results.

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