Biopsy and histology of the cervix in dysplasia

Biopsy - this word frightens many women, although the procedure itself is not a danger. Only its result can alarm, which is not always bad. Cervical biopsy for dysplasia is rather designed to exclude the risk of oncology and is one of the most common procedures in a comprehensive survey of women.

[1], [2], [3], [4]

Description of the procedure, how does a cervical biopsy occur with dysplasia?

• A biopsy is a fence of a small amount of epithelial tissue for examination.
• The procedure uses a very thin special needle with a cavity.
• A biopsy is performed during colposcopic examination.
• The needle is inserted into the epithelial tissue after applying a local anesthetic.
• The resulting biopsy material is sent to the laboratory for histological examination.
• The cell material undergoes a special treatment (staining) and is examined under a microscope.
• Histology makes it possible to determine how much dysplasia of the cervix is dangerous. The safety of the cell structure, their morphology, and the number of layers of tissue are evaluated.
• The analysis allows to determine the extent of epithelial tissue damage and to clarify the preliminary diagnosis.

Biopsy is considered a highly informative method, plus this procedure is that it is practically painless and refers to minimally invasive methods of examination

[5], [6]

Histology for cervical dysplasia

Histological examinations are included in the diagnostic complex, if a gynecologist at a primary examination found a woman with cervical dysplasia. It is histology that makes it possible to clarify the diagnosis, exclude or confirm cancer, carcinoma.

Let us consider in more detail what histology is:

• Histology is a method that studies the structure of the tissue, reveals all the deviations in the cellular structure.
• The basis of histology is the investigation of the cut of the tissue material, in this case the epithelium of the cervix.
• The difference between histology and cytology is that with a biopsy a deeper fence is taken. Cytology involves scraping from the surface of the cervical epithelium.
• Histology is performed during a colposcopic examination. Most often after the initial colposcopy, which determines the site of the biopsy sampling.
• Histological examination is not considered difficult, except for cases when the lesion of the epithelium is not expressed explicitly and it is required to conduct several biopsies from different sectors of the cervix
• The obtained biopsy specimen is examined by staining. Normally, the epithelial tissue shows a brown color after staining. If there are pathological changes, the color of the tissue varies little or the material does not change color at all.
• In histology, the neck tissue is damaged to avoid infection or bleeding, the site can be sutured. But most often after a biopsy a sterile hemostatic tampon is used, which copes well with the function of tissue protection and regeneration.

What methods can histology be used?

• Standard biopsy with a special hollow needle.
• Excision of a small area of tissue with a special medical electronic knife (diathermic excision).
• Laser excision.
• Excision with the help of the latest modern instrument - a radio-knife.
• Fence tissue using a scalpel.

 Recommendations for histological tissue sampling

• This is the least traumatic and suitable method for young, nulliparous women.
• If the proposed altered area of the epithelium is small, in any sector of the cervix the fence is carried out in a gentle manner.
• For histology, preliminary diagnostic procedures are mandatory - examination, cytology, colposcopy.

The normal results of histology do not exclude the need for regular examinations and diagnostics. A visit to a gynecologist at least once a year should be the norm for every sensible woman, since dysplasia of the cervix can develop asymptomatically and without any characteristic signs.

By what criteria is the diagnosis determined after a biopsy?

• If there are violations in the structure of the layers of the epithelium.
• When the outer layer shows the activity of cell maturation (increased ribosomes).
• If a decrease in the synthesis of specific glycogen is determined.
• Cell contact (desmos) is reduced.
• The nucleus of the cell is prone to pathological changes.
• Obviously visible atypical mitochondria, other non-standard constituents of cell DNA.
• Changes in the cellular form (cylindrical).

Degree of epithelial cell damage:

1. The first - background changes, are weakly expressed.
2. Moderate, second degree - atypical changes are expressed in half of all layers.
3. Severe atypia, the third degree - changes affected two or more layers of the epithelium.

[7], [8], [9], [10], [11], [12]