Dysplasia of the cervix. Cervical dysplasia How a biopsy is done in certain organs and tissues

Dysplasia of the cervix - SYMPTOMS

In the previous article, we examined the causes of development and methods of treating cervical erosion. , and this article describes the symptoms characteristic of grades 1 and 2 of cervical dysplasia, research and diagnostic methods ( biopsy and colposcopy), treatment of dysplasia ( cauterization, conization, radio wave removal of pathological tissues consisting of atypical cells cervix).

cervical dysplasia is damage to the epithelium of the cervix with the formation of atypical cells in it. In other words, cervical dysplasia is accompanied by the growth of degenerate cells. They are clearly visible in the photo. Such mutant cells can only be detected on the surface of the cervix . With untreated cervical dysplasia, degenerate cells have the ability to penetrate deep into, thereby causing cancer.

Stages of the disease depend on the depth of penetration of diseased cells into the tissue. Therefore, it can occur in mild, moderate and severe forms. Any of them is amenable to timely treatment.

Any degree of dysplasia can be called a precancerous condition. However, only in 40-64%, according to statistics, it turns into a preinvasive tumor. . It must be emphasized that women who have cervical dysplasia or erosion , without fail, must be observed constantly by a gynecologist. Consultations with a specialist will allow you to timely prescribe the most gentle conservative or surgical treatment for mild 1st degree dysplasia.

Conducting an annual diagnosis of cervical dysplasia can prevent the disease. Diagnostics includes the following studies:

* smear microscopy. A general smear allows you to detect chronic or acute inflammation;

*examination in gynecological mirrors. Such an examination allows the specialist to visually assess the condition of the vaginal walls and cervix;

* tissue cytology cervix;

* biopsy doubtful area of ​​the cervix according to indications;

* extended colposcopy cervix.

Cervical dysplasia: characteristic symptoms

- A characteristic feature of the disease is that it almost does not have an independent clinical picture. In 10% of women, dysplasia is latent and symptoms practically do not appear at the initial first and even at the 2nd stage of the disease. Sometimes cervical dysplasia is detected at the next examination by a gynecologist.

One of the first manifestations of cervical dysplasia can be considered symptoms of aching pain in the lower abdomen , which increase towards the beginning of menstruation. Generally severe pain with dysplasia not visible.

Another symptom diseases - sometimes genital warts appear.

Often, cervical dysplasia is accompanied by a microbial infection, which is characterized by signs of cervicitis and colpitis - discharge strange color , odor and consistency, as well as symptoms such as itching and burning . Sometimes after using tampons or having sex, there may be discharge with blood .

The course of the disease can be long. Cervical dysplasia sometimes regresses if the inflammation is treated appropriately . But, as a rule, the inflammatory process of the disease is progressive.

Risk groups among women who are more likely to develop cervical dysplasia:

* An indirect cause of dysplasia can be malnutrition with a poor diet. Therefore, women whose diet contains little vitamins A and C may be at risk. In this case, the work of the female body may be disrupted at the cellular level;

* women who have given birth to many children. Dysplasia may occur due to the fact that the cervix during childbirth been injured many times;

* the beginning of an intimate life before the age of sixteen;

* Patients with venereal and other diseases that can be sexually transmitted. In this case, immunity is significantly reduced. Therefore, it can cause the development of cervical dysplasia. In addition to this, those microorganisms that are present in such diseases in the genital organs can adversely affect the cervix. . Benign cells can degenerate into malignant;

* women who are carriers of papillomavirus person. Those who have such papillomas on the genitals are especially at risk;

* frequent change of close partners leads to an increased risk of cervical dysplasia;

* taking more than 5 years of hormonal contraceptives can disrupt the normal production of hormones, causing a hormonal imbalance in the woman's body ;

* long-term replacement therapy also leads to dysplasia. There is evidence that the use of oral contraceptives leads to a significant increase in the risk of precancerous and cancerous diseases of the genital organs. But this does not apply to contraceptives that contain only progestins;

* Women who smoke are one of the risk groups;

* women who have had abortions, various infections, operations on the cervix, as well as those who have bacterial vaginosis ;

* lack of basic rules of personal hygiene ;

* AIDS patients suffer from reduced defense mechanisms of the body and, as a result, have a violation of all organs, including reproductive organs.

In addition to all the above reasons, hypothermia against the background can also cause this gynecological disease.

1, 2 AND 3 DEGREES OF CERVICAL DYSPLASIA

The depth of changes in the cells is a sign by which the degree of cervical dysplasia is determined. They may be as follows:

* cervical dysplasia, related to 1 degree , characterized by small changes in the cells. It belongs to the mild form. Changes concern only the lower layer in the squamous epithelium of the vaginal part of the cervix.

Dysplasia of the 1st degree, as a rule, in 50-60% of cases, with the help of the protective forces of the female body, it can independently develop in the opposite direction. Sometimes cervical dysplasia is accompanied by urogenital infections. . In such cases, it is first necessary to get rid of infectious diseases before starting treatment for the first degree of cervical dysplasia. Most likely, it is these infections that are the causes of dysplasia.

If it turns out that the pathology does not regress, then surgical treatment (conization of the cervix) can be undertaken. But then dysplasia will already pass into the second or third degree of severity.

Timely detected dysplasia of the 1st degree is cured using conservative methods without any negative consequences for the general and reproductive health of the woman (already a month after the treatment of dysplasia, you can fearlessly conceive and normally bear a child throughout pregnancy period ). These include sanitation of the main focus of infection, immunostimulating therapy and a course of anti-inflammatory treatment.

The causes of cervical dysplasia in 97% of cases are human papillomaviruses, HPV-16, HPV-18 and others.

Dysplasia appears, as a rule, 1-1.5 months after penetration into the mucous membrane of the cervix. In order not to miss the beginning of the process, it is necessary to visit the gynecologist twice a year annually;

* moderate cervical dysplasia belongs to the 2nd degree . It is characterized by changes in the epithelial cells of the lower and middle thirds. Morphological progressive changes in the epithelium, as a rule, with stage 2 dysplasia of the cervix, approximately 60-70% are affected.

The second degree of cervical dysplasia is treated depending on the results of preliminary tests. The main ways to treat this degree of dysplasia are:

- Therapy that improves immunity. This method is effective with a large lesion of the epithelium, if there is a tendency to relapse;

radio wave therapy;

Argon or carbon dioxide laser;

Electrocoagulation;

Surgical methods - destruction of the affected area of ​​the mucosa with the help of conization of the cervix by freezing (cryotherapy).

It must be emphasized that with 1 and 2 degrees of cervical dysplasia, a pregnant woman has the opportunity give a birth to a baby . This happens if the affected areas are small and the woman is at a young age. Experts are cautiously waiting for the moment when a woman can become a mother , since the tissue of the cervix should heal. There is a high probability that the affected area will heal on its own. A woman in such cases should take the necessary tests once every 3-4 months;

* for severe cervical dysplasia grade 3 characterized by a change in the cells of all three layers of the epithelium. Such changes are called non-invasive cancer. This severe form of dysplasia is also called cervical intraepithelial neoplasia (CIN - carcinoma in situ). Changes in the cells cover the entire thickness of the keratinized epithelium, hyperchromic cells appear, there is a large proliferation of cells of the parabasal and basal layers, in the cells of the nuclear-cytoplasmic ratio, violations are fixed towards an increase in the nucleus. Below you can see a photo with the image of the cervix 1, 2 and 3 degrees of dysplasia.


In the case of damage to the epithelium of the 3rd degree, a smear for atypical cells does not provide comprehensive information. It is necessary to investigate the thickness of the tissue. In addition, grade 3 cervical dysplasia requires a visit to an oncologist. To clarify the diagnosis, he can conduct a separate diagnostic curettage. If the diagnosis is confirmed, radical surgical treatment of dysplasia is chosen - high conization of the cervix.

DIAGNOSIS METHODS - BIOPSY AND COLPOSCOPY OF THE CERVIC IN DYSPLASIA

COLPOSCOPY OF THE CERVIC

Colposcopy of the cervix is ​​a method of examination using a special apparatus - a colposcope. In the early stages of the disease, colposcopy is facilitated by the physiological eversion of the lower cervical canal.

There are several types of cervical colposcopy. The main ones are simple, extended, color and luminescent.

Simple colposcopy of the cervix- a woman is examined on a gynecological chair, introducing a gynecological mirror inside for a better view. Inspection of the cervix is ​​carried out using a colposcope.

Extended colposcopy of the cervix- all stages are carried out, as with a simple colposcopy. In addition, the uterine mucosa is stained with Lugol's solution and 3% acetic acid solution. This method contributes to a clearer identification of lesions. When the lining of the uterus is stained , it turns brown. The lesions, at the same time, become white (with a white coating, whitish).

Color colposcopy of the cervix- a similar procedure, however, the solutions used are those that, when stained, make the cervix green or blue. This method allows you to examine in detail the lesions and the vascular network.

Fluorescent colposcopy of the cervix- This method is used to detect cancer cells. The cervix with this method is treated with fluorochromes. The next step is to check with ultraviolet light. Thus, the foci of cancer cells are highlighted in pink.

Colposcopy during pregnancy is an absolutely safe procedure for the pregnant woman herself and for the unborn child . Therefore, if you planned pregnancy , you need to carry out all the necessary research in advance and be sure to cure cervical dysplasia. Moreover, now with the help of modern technologies it is possible to carry out an effective treatment of the disease, moreover, without any consequences for future pregnancy.

The colposcopy procedure can in no way affect the health of the pregnant woman or the course of the pregnancy. . However, it is usually prescribed after a gynecological examination by a specialist and a smear examination. If a gynecologist suspects a woman has cervical erosion, he may prescribe a colposcopy for her. This is done to obtain more detailed information about the alleged pathology. In case of confirmation of the diagnosis of cervical erosion, it is recommended to conduct colposcope examinations as control measures every three months.

Colposcopy helps to detect pathologies, including precancerous diseases. It will also allow you to correctly decide whether to perform a caesarean section. or childbirth will take place naturally. It depends on the existing cervical erosion and its degree.
It must be noted that colposcopy at later stages of pregnancy is very difficult. This can occur due to congestion and hypertrophy of the cervix. For a more detailed study, cervical biopsy.

Pregnant women for colposcopy it is worth choosing a very qualified and professional specialist. This is especially important when conducting an extended study. Pregnant women cannot be assigned the use of chemicals . Specialists replace them only with soft pharmaceuticals.

The main purpose of the study using colposcopy is to predict the likely composition of the cells of the cervical mucosa. This is necessary for the detection of cervical cancer and precancerous lesions.

Colposcopy cannot be used to make a diagnosis. It only allows you to find the area of ​​greatest damage. This, in turn, is very important for conducting a targeted biopsy of the cervix.

cervix biopsy

If a woman has cervical dysplasia, then against the background of pathological cytology, the next step will be a biopsy of the affected cervix. A biopsy of the cervix consists of taking a small piece to be examined under a powerful microscope. The procedure is done under local anesthesia . Then, after a biopsy of the cervix, an accurate diagnosis can be made, according to which a correct follow-up plan can be carried out, as well as the necessary method of treating the disease can be applied.

Biopsy of the cervix allows for an accurate definitive histological diagnosis.

Usually, cervical biopsy carried out for those women who have abnormalities during colposcopy along with the detection of human papillomaviruses with a high oncogenic risk of types 16 or 18, or the results of a PAP test of grades 3, 4 or 5.
The biopsy procedure consists of a small operation. To do this, a woman must undergo some training. She is prescribed clinical, biochemical and bacteriological studies. Then the woman must give written consent to the operation. The signed document should indicate all possible complications during the operation. If the biopsy is scheduled with the use of anesthesia, then the woman should not eat and drink for 12 hours before the biopsy. The biopsy procedure is performed immediately after the end of menstruation.

As a rule, an outpatient biopsy takes place without anesthesia, and in a hospital - with its use. In principle, the cervix has no pain receptors and does not require anesthesia. Anesthesia is required only for women with a highly excitable nervous system.

So, to detect cervical dysplasia, a piece of tissue is taken approximately 5 mm wide and 3-5 mm deep from the most suspicious area. If there are several suspicious lesions, tissues are taken from each of the sites. In some cases, they use conization of the cervix. This allows you to completely remove lesions on the cervix. In such cases, the biopsy will be both diagnostic and therapeutic.

The best option in modern conditions is to conduct tissue sampling using a radio wave or ultrasonic scalpel. In this case, an even cut will be obtained, the structure of the tissue will not be disturbed, there is no need to stop the bleeding, since it is absent.

The resulting tissue pieces during biopsy are placed in a formaldehyde solution. They must be signed, and then sent to the laboratory for histological examination.

After a biopsy of the cervix, a woman is supposed to write out a sick leave for two days. In cases where a biopsy is performed directly in a hospital, sick leave is issued for 10 days.

In a clinic, it is necessary to conduct an examination of the cervix no later than one and a half months. If there are no deviations, then the woman is allowed to have sex.

METHODS OF TREATMENT OF THE CERVIC

At the moment, the most effective and safe for women's health methods of treating dysplasia are cauterization with radio waves and conization of the cervix.
Cervical dysplasia requires a complete examination of a woman in order to carry out further effective treatment. Such an examination involves colposcopy, analysis of smears for microflora and cytology, endocervical curettage, sometimes a biopsy.

Methods of treatment of the cervix can be divided into general and local. In case of cervical dysplasia, the treatment performed will depend on the professionalism of specialists, including the level of their knowledge and technical skill in conducting surgical treatment.

Cervical Dysplasia: General Treatment

Orthomolecular Therapy in the treatment of cervical dysplasia involves the use of a number of drugs that affect the regeneration of the normal state of the cervical epithelium.

There is a direct relationship between the appearance of cervical dysplasia and a deficiency of vitamins A and C. Therefore, all women are recommended to take these vitamins both for the prevention of cervical dysplasia and for its treatment. In addition, a huge role in the regeneration of the epithelium belongs to the following vitamins: B6, E, beta-carotene, B12, folic acid and bioflavonoids, in particular oligomeric proatocyanidins (OPCs).

A huge role in the treatment of cervical dysplasia is played by Omega-3 (polyunsaturated fatty acid), selenium, prebiotics, probiotics, fiber, enzymes such as bromelain and pancreatin.

Medical treatment of dysplasia

In a number of countries, the most popular method of treating cervical dysplasia is the method of chemical coagulation (vagotid, solkogin, etc.). It is used mainly in the treatment of mild dysplasia, when there are small lesions in depth and area. The second and third degree of dysplasia are not amenable to such treatment. Using this method, ectopic columnar epithelium is treated. Moreover, the effect of treatment is much higher than with squamous epithelium dysplasia.

In most cases abroad, this method of coagulation is not used, since it leads to burns of the cervix and vaginal mucosa. In addition, this method is not recommended for use as a self-treatment.

Conservative treatment of dysplasia

The use of conservative treatment requires a large number of drugs of inorganic and organic origin. These include: mineral salts, mineral water, oil and decoctions of medicinal plants (eucalyptus, chamomile, thistle, calendula, St. - biological tissues (placenta), etc.

Modern surgical methods for the treatment of cervical dysplasia include:

- Diathermocoagulation(or electrical excision, cauterization). But there is a big disadvantage of this method - after the operation of cauterization of the neck by diathermocoagulation, there is a high risk of developing endometriosis in a woman.

- Cryosurgery(cryoconization, cold destruction of the cervix). The method of treatment of cervical dysplasia, which is used after a thorough biopsy of the affected tissues . The method is very effective, but rarely used for severe, grade 3 dysplasia in a woman. After the operation, specific discharge can be observed for a rather long time (lymphatic discharge is released from the lymphatic vessels).

- Laser treatment of dysplasia. It is performed under a short general anesthesia, as the operation can be quite painful. After laser conization of the cervix with dysplasia, mild bleeding may occur after 5-12 days.

- Treatment of dysplasia with ultrasound therapy. It is used in Russia, Kazakhstan and some other countries of the former Soviet Union. The method has not passed the European certification, since the possible side effects in the postoperative period are still poorly understood (how safe is the ultrasound treatment of cervical dysplasia for subsequent normal conception? and bearing a child during pregnancy ).

Below we will take a closer look at all the popular and proven methods of treating cervical dysplasia in women of degrees 1,2 and 3.

Cauterization and discharge after cauterization of the cervix

If a woman is planning a pregnancy , then it is imperative to cure erosion and dysplasia of the cervix. The fact is that the uterus affected by erosion or dysplasia at the opening during childbirth becomes more rigid. As a result, there may be breaks. If there is erosion of a sufficiently large size, then there is a risk of its transition to a malignant state. Therefore, the risks of such a disease are quite high.

Cauterization of the cervix, or the so-called physiosurgical treatment for erosion and dysplasia, can affect tissue changes in various ways:

*cryodestruction- cauterization of the cervix with liquid nitrogen. This method is effective for the treatment of both 2 and 3 degrees of dysplasia. This method is the most gentle in the treatment of dysplasia and erosion. Liquid nitrogen acts on tissue areas and cools them (freezes). When this occurs, the destruction of cells. Cauterization of the cervix with nitrogen is a painless and safe procedure. After cauterization of the cervix, it heals within 8-10 weeks. After cryodestruction, there are no scars or scars. This method may be recommended for women who planning to have another child or nulliparous women. The disadvantage of this method is that incomplete freezing of tissues is possible, so there is a possibility that not all cells affected by the disease will die;

* radio wave destruction- cauterization of the cervix of a special frequency with radio waves. It is indicated for the treatment of 1, 2 and 3 degrees of dysplasia in women. Experts consider radio wave surgery to be a very promising way to treat cervical pathology. This is especially true for precancerous diseases. The fact is that radio waves contribute to an increase in the internal energy of altered cells, which leads to the destruction of the cell. This treatment is painless and fast. The main advantages of the radio wave method include - reduction of operation time, minimal tissue destruction, complete healing without a scar within 30 days;

* electrocoagulation (diathermocoagulation)- impact on the pathological tissue area with the help of electric current. In this case, the affected tissue is removed. Complete healing occurs after 2-3 months. Sometimes, after cauterization of the cervix, discharge in the form of blood may appear. Cauterization of the cervix with an electric current contributes to the loss of elasticity, the appearance of scars. This can lead to complications in future pregnancy and childbirth. Electrocoagulation is recommended for the treatment of grade 3 dysplasia, for women who have given birth to eliminate benign uterine erosion;

* laser coagulation- a painless and effective way to cauterize the cervix. Restoration of the site of the operation occurs within 1-2 months. It depends on the complexity of the operation. This method almost does not give complications and does not leave scars. Its advantage is that it is carried out without anesthesia in a few minutes. There are no relapses after the laser;

* electroconization- recommended if women have severe, grade 3 cervical dysplasia. Conization is the removal of the cone-shaped part of the cervix under local anesthesia. This method allows you to remove atypical cells in the entire thickness of the epithelium.

Conization is used in cases where it was not possible to eliminate the pathological focus of dysplasia by the physiosurgical method. With the removed part of the cervix, pregnancy is possible . However, in such cases, experts recommend the imposition stitches on the cervix . This must be done to avoid premature birth.

Discharge after cauterization of the cervix

Discharges that are observed in some women during the recovery period after cauterization of the cervix, are the norm. Strong clear discharge may indicate ongoing processes of regeneration of the mucous membrane.

Small dark red discharge , and then a light pink color indicate an ordinary wound separation. They shouldn't bother women. Modest bleeding will surely disappear after cauterization of the cervix after 2 weeks. The method of cryotherapy is considered bloodless. Accordingly, after it there is no bleeding.

Many methods of cauterization of the cervix promote healing in 1-2 months. It does not require a special gynecological examination. However, if you have any discharge after this period, you should consult a gynecologist. The discharge before menstruation is also not the norm. after cauterization of the cervix. In this case, it is also necessary to examine a specialist to find out the reasons.

CONIZATION AND RADIOWAVE TREATMENT OF THE CERVIC

Conization of the cervix considered a gynecological operation. There are currently three main methods of conization of the cervix.
When choosing a method of conization of the cervix, it is necessary to take into account the type of changes on the cervix. They may be superficial. They can be found with colposcopy. Other changes are found inside the cervix, in the so-called submerged transformer zone. An important point in choosing the method of conization is the planning of a new pregnancy by a woman.

The decision on a specific method of treatment should be made by a specialist, taking into account all contraindications and indications. Do not self-medicate erosion. This is especially true for folk remedies, sometimes life-threatening. This applies to poisonous plants, with the help of which it is possible to get burns of healthy mucous membranes. The doctor will be able to choose an effective treatment option based on the optimal method of therapy.

Radio wave treatment of the cervix

This method of conization of the cervix is ​​also called loop. Now this is the most common way. This method uses a modern radio wave surgery apparatus, consisting of an electric generator. A set of electrodes is attached to it, including in the form of a loop.

Radio wave conization is sometimes accompanied by an unpleasant odor. Often this happens due to the lack of a mini-hood in the device. In addition, there may be slight pain in the lower abdomen. There may be slight tingling during the procedure. But it quickly disappears.

Radio wave treatment of the cervix, depending on the degree of damage to the mucous membranes and existing concomitant diseases, has a different cost.

Laser method of conization of the cervix

This method uses surgical KTP lasers or CO2 lasers. After conization of the cervix by this method, excessive charring of the tissues occurs. Therefore, this method is inferior in terms of capabilities to radio wave treatment of the cervix.

Knife method of conization of the cervix

This method is a surgical procedure using a scalpel.

What happens after conization of the cervix in the postoperative period?

The postoperative period is characterized by pain in the lower abdomen . Some days they look like for pain during menstruation . As for the menstruation itself, it can be much more intense. Possible brown discharge during menstruation .
The wound after the operation should heal well. Therefore, in the first 4 weeks, sexual relations are prohibited, you can also not go to the sauna, bath, it is recommended to refrain from physical exertion.

In the postoperative period, it is not recommended to use aspirin, as it inhibits the healing process of the wound.
Sometimes the discharge does not stop even 3 weeks after the operation. They acquire an unpleasant odor. The temperature rises, the pain does not subside. In such cases, it is urgent to contact a gynecologist. There is a possibility that an infection or other complication has appeared.

Postoperative period after conization of the cervix

Sometimes the consequences of conization are problems with conception. This applies mainly to those cases where the operation was performed more than once or a significant part of the cervix was removed. In these cases, the patency of the cervical canal worsens.

There is an opinion that the consequence of conization is the loss of elasticity of the cervix, as a result of which it will be impossible for a woman to give birth naturally. In some cases, the cervix after conization becomes, like in a nulliparous woman, smooth and healthy, elastic, without seams.

However, in cases where the cervix shortens after conization, there is a risk that the cervix may dilate prematurely. This can happen under the weight of the uterus with the baby. The gynecologist in such cases should suture the cervix. This seam will keep it closed. The suture is removed before labor starts.

Postoperative period after radio wave treatment of the cervix

Radio wave treatment of cervical dysplasia should be carried out at the beginning of the menstrual cycle - between 5 and 10 days. Following this rule will allow the tissues to heal faster. With slight erosion, the tissues have time to recover before the onset of subsequent periods.

For about a week after the operation, there may be slight colorless or smearing brown discharge. They only mean that the normal healing process is going on. To completely cure the disease, one procedure will be enough. After two weeks, it is necessary to examine the condition of the tissues by a gynecologist.

After radio wave treatment of the cervix, it is necessary to exclude sexual intercourse for one month, as well as physical activity, swimming in the sea, lake, pool, taking baths or saunas for 2-4 weeks. Please note that it is forbidden to lift any object that exceeds the weight of 3 kilograms.

Each individual case requires specific recommendations. It all depends on the degree of erosion. This applies to sexual intercourse and other prohibitions.

FOLK TREATMENT OF THE CERVIC

Alternative treatment of cervical erosion can be carried out only at the very beginning of the disease. In such cases, the use of anti-inflammatory drugs will be sufficient.

The main thing in the treatment of the cervix with folk remedies is the duration and regularity.

For the treatment of the cervix with folk remedies, the following recipes are used:

- one of the popular folk remedies in the treatment of the cervix at home is propolis. Propolis tincture is used as an excellent healing and antibacterial agent. Every evening, propolis ointment must be smeared on a tampon and inserted into the vagina. This evening procedure must be carried out for 10 days;

Treatment with tampons with sea buckthorn oil is carried out for 10-12 days. This treatment is recommended for pregnant women for the treatment of cervical erosion;

For douching, such a folk remedy as a decoction of St. John's wort is often used. . It is easy to prepare at home. To do this, you need to take 4 tablespoons of dry St. John's wort, and then pour it with two liters of water. St. John's wort boil for 10 minutes over low heat. Then it is necessary to stand the infusion for an hour and strain;

For douching and internal use, use the root of bergenia. To do this, chopped bergenia root (about three tablespoons) should be brewed with one glass of boiling water in a metal bowl. Put on fire and cook until the water has evaporated by half. This decoction of bergenia should be used for douching, after diluting it in 300 grams of boiled water. For internal daily use, 30 drops 3 times a day are enough. Be sure to drink the decoction with water;

It is believed that calendula tincture will help well with erosion, which is caused by inflammatory infections. In order to prepare such a solution, you need to mix one teaspoon of 2% calendula tincture in 50 grams of water. It is recommended to douche with this solution three times a week. Treatment of the cervix with folk remedies can be used at home only after a thorough examination by a doctor who will prescribe the necessary tests, as well as a study of deformed uterine tissues (biopsy and colposcopy) to make an accurate diagnosis. Treatment of 2, as well as severe 3 degrees of cervical dysplasia exclusively by alternative methods, can lead to severe complications of the disease and the inability to become pregnant in the future.

Content

Existing methods of laboratory research significantly facilitate diagnosis, allow the patient to proceed to intensive care in a timely manner, and speed up the recovery process. One of such informative diagnostics in a hospital setting is a biopsy, during which it is possible to determine the nature of pathogenic neoplasms - benign or malignant. Histological examination of biopsy material, as an invasive technique, is carried out by knowledgeable specialists exclusively for medical reasons.

What is a biopsy

In fact, this is the collection of biological material for further examination under a microscope. The main goal of the invasive technique is to timely detect the presence of cancer cells. Therefore, a biopsy is often used in the complex diagnosis of oncological diseases. In modern medicine, it is possible to obtain a biopsy from almost any internal organ, while simultaneously removing the focus of pathology.

Such a laboratory analysis, due to its pain, is performed exclusively under local anesthesia; preparatory and rehabilitation measures are required. A biopsy is an excellent opportunity to timely diagnose a malignant neoplasm at an early stage in order to increase the patient's chances of maintaining the viability of the affected organism.

Why take

A biopsy is prescribed for the timely and rapid detection of cancer cells and the accompanying pathological process. Among the main advantages of such an invasive technique, carried out in a hospital, doctors distinguish:

• high accuracy of tissue cytology determination;
• reliable diagnosis at an early stage of pathology;
• determination of the scale of the upcoming operation in cancer patients.

What is the difference between histology and biopsy

This diagnostic method deals with the study of cells and their potential mutation under the influence of provoking factors. A biopsy is a mandatory component of the diagnosis of oncological diseases, and is necessary to take a tissue sample. This procedure is performed under anesthesia with the participation of special medical instruments.

Histology is considered an official science that studies the structure and development of tissues of internal organs and body systems. The histologist, having received a sufficient piece of tissue for examination, places it in an aqueous solution of formaldehyde or ethyl alcohol, then stains the sections using special markers. There are several types of biopsy, histology is performed in a standard sequence.

Kinds

With prolonged inflammation or suspicion of oncology, it is necessary to conduct a biopsy, excluding or confirming the presence of an oncological process. First, it is required to perform a general analysis of urine and blood to identify the inflammatory process, to implement instrumental diagnostic methods (ultrasound, CT, MRI). The sampling of biological material can be carried out in several informative ways, the most common and popular among them are presented below:

1. Trepan biopsy. It is carried out with the participation of a thick needle, which in modern medicine is officially called a "trephine".
2. Needle biopsy. The sampling of biological material is carried out by the method of puncturing a pathogenic neoplasm with the participation of a thin-field needle.
3. incisional biopsy. The procedure is carried out during a full-fledged operation under local anesthesia or general anesthesia, it provides for the productive removal of only part of the tumor or the affected organ.
4. Excisional biopsy. This is a large-scale procedure, during which a complete excision of an organ or a malignant tumor is performed, followed by a rehabilitation period.
5. Stereotactic. This is a diagnosis carried out by the method of preliminary scanning, for the further construction of an individual scheme for the purpose of surgical intervention.
6. Brush biopsy. This is the so-called "brush method", which involves the use of a catheter with a special brush to collect a biopsy (located at the end of the catheter, as if cutting off the biopsy).
7. Loopback. Pathogenic tissues are excised using a special loop (electric or radio wave), in this way a biopsy is taken for further research.
8. Liquid. This is an innovative technology for detecting tumor markers in a liquid biopsy, blood from a vein, and lymph. The method is progressive, but very expensive, not carried out in all clinics.
9. Transthoracic. The method is implemented with the participation of a tomograph (for more thorough control), it is necessary for taking biological fluid mainly from the lungs.
10. Fine needle aspiration. With such a biopsy, the biopsy specimen is forced to be pumped out using a special needle for exclusively cytological examination (less informative than histology).
11. Radio wave. A gentle and absolutely safe technique, which is carried out with the help of special equipment - Surgitron in a hospital. Does not require long rehabilitation.
12. Preskalennaya. Such a biopsy is involved in the diagnosis of the lungs, it consists in taking a biopsy from the supraclavicular lymph nodes and lipid tissues. The session is carried out with the participation of a local anesthetic.
13. Open. Officially, it is a surgical intervention, and tissue sampling for research can be performed from an open area. It also has a closed form of diagnosis, which is more common in practice.
14. Core. Soft tissue sampling is performed using a special trephine with a harpoon system.

How do they do

The features and duration of the procedure itself completely depend on the nature of the pathology, the location of the alleged focus of the pathology. Diagnosis should be controlled by a tomograph or an ultrasound machine, it must be carried out by a competent specialist in a given direction. The options for such a microscopic examination are described below, depending on the organ that was rapidly affected in the body.

In gynecology

Carrying out this procedure is appropriate for extensive pathologies not only of the external genital organs, but also of the uterine cavity, its cervix, endometrium and vagina, and ovaries. Such a laboratory study is especially relevant for precancerous conditions and suspected progressive oncology. The gynecologist recommends undergoing such types of biopsy strictly for medical reasons:

1. Sighting. All actions of a specialist are strictly controlled by extended hysteroscopy or colposcopy.
2. Laparoscopic. More often, the technique is used to take biological material from the affected ovaries.
3. Incisional. It provides for a careful excision of the affected tissues with a classic scalpel.
4. Aspiration. In this case, a biopsy specimen can be obtained by the vacuum method using a special syringe.
5. Endometrial. Pipel biopsy is possible with the help of a special curette.

Such a procedure in gynecology is an informative diagnostic method that helps to identify a malignant neoplasm at an early stage, timely proceed to effective treatment, and improve the prognosis. With a progressive pregnancy, it is advisable to refuse such diagnostic methods, especially in the first and third trimesters, it is first important to study other medical contraindications.

Blood biopsy

Such a laboratory study is considered mandatory if leukemia is suspected. In addition, bone marrow tissue is taken for splenomegaly, iron deficiency anemia, and thrombocytopenia. The procedure is performed under local anesthesia or general anesthesia, performed by aspiration or trepanobiopsy. It is important to avoid medical errors, otherwise the patient may suffer greatly.

Intestine

This is the most common method of laboratory examination of the intestines, esophagus, stomach, duodenum and other elements of the digestive system, which is carried out with the participation of puncture, loop, trepanation, pluck, incisional, scarification technology, necessarily in a hospital. Preliminary anesthesia is necessary, followed by a rehabilitation period.

In this way, it is possible to determine the change in the tissues of the mucous membrane of the digestive tract, to recognize the presence of cancer cells in a timely manner. In the stage of recurrence of a chronic disease of the digestive system, it is better not to conduct a study in order to avoid gastric bleeding or other potential complications. Laboratory research is prescribed only on the recommendation of the attending physician, there are contraindications.

hearts

This is a complex procedure that, if a medical error can cost the patient his life. Use a biopsy for suspected serious diseases such as myocarditis, cardiomyopathy, ventricular arrhythmia of unknown etiology. Due to the rejection of the transplanted heart, such diagnostics are also needed to control stable positive dynamics.

More often, modern cardiology recommends conducting a right ventricular examination, accessing the focus of pathology through the jugular vein on the right, subclavian or femoral vein. To increase the chances of success of such a manipulation, fluoroscopy and ECG are used during the taking of biological material, and the process is monitored on the monitor. The essence of the technique is that a special catheter is advanced to the myocardium, which has special tweezers for “biting off” biological material. To exclude thrombosis, medicine is injected into the body through a catheter.

Skin

An invasive examination of the epidermis is necessary for suspected skin cancer or tuberculosis, lupus erythematosus, psoriasis. An excisional biopsy is performed by shaving the affected tissues with a column for the purpose of their further microscopic examination. If a small area of ​​the skin is deliberately damaged, after the session is completed, it must be treated with ethyl or formic alcohol. With large amounts of damage to the dermis, suturing may even be required in compliance with all asepsis rules.

If the focus of the pathology is concentrated on the head, it is necessary to examine a skin area of ​​2-4 mm, after which a suture will be applied. It can be removed as early as a week after the operation, but for skin diseases, this biopsy method is the most informative and reliable. It is not recommended to take biological material with visible inflammation, open wounds and suppuration. There are other contraindications, so an individual consultation with a specialist is required first.

bone tissue

The indicated session is necessary for the detection of oncological diseases, it is an additional diagnostic method. In such a clinical picture, it is indicated to carry out percutaneous puncture with a thick or thin needle, depending on medical indications, or by a radical surgical method. After receiving the first results, there may be an urgent need to re-examine a similar biopsy.

Eye

If you suspect the development of retinoblastoma, an urgent biopsy is necessary. Action is required immediately, since such a malignant neoplasm very often progresses in childhood, can cause blindness and death for a clinical patient. Histology helps to give a real assessment of the pathological process and reliably determine its extent, predict the clinical outcome. In such a clinical picture, the oncologist recommends an aspiration biopsy technique using vacuum extraction.

FGDS with biopsy

To understand what will be discussed, it is required to make such a decoding of the FGDS abbreviation. This is fibrogastroduodenoscopy, which is an instrumental study of the esophagus, stomach and duodenum with the involvement of a fiber optic endoscope. When carrying out such a procedure, the doctor gets a real idea of ​​​​the focus of the pathology, moreover, he can visually examine the state of the affected digestive system - tissues and mucous membranes.

A biopsy is performed under local anesthesia, therefore it is an absolutely painless diagnostic method. This is especially important for patients at risk of gag reflex. A distinctive feature of this diagnostic is the ability to detect Helecobacter infection and the degree of damage to the organs of the digestive system, mucous membranes.

Material research methods

After the biological material is obtained, it can be followed by a detailed study under a microscope to timely identify the nature of the pathological process. The most common and popular research methods and their brief description are presented below:

1. Histological examination. In this case, tissue sections taken from the body (exclusively from the surface or contents of the pathology focus) are under observation. Using a special tool, the biological material must be cut into strips of 3 micrometers, after which, in order to detect cancer cells, it is necessary to stain the sections of such “strips”. Then the prepared material is examined under a microscope to determine the presence of cancer cells hazardous to health in the structure.
2. Cytological study. This technique has a fundamental difference, which consists in the study of not affected tissues, but cells. The method is less informative, but is used if an insufficient amount of biological material was taken for histological examination. More often, cytology is performed after a fine-needle (aspiration) biopsy, taking swabs and swabs, which also causes discomfort when taking biological material.

How long to wait for the result

If we talk about histological examination, the reliability of laboratory research is 90%. There may be errors and inaccuracies, but it depends on the morphologist who did not correctly take the sample, or use obviously healthy tissues for diagnosis. Therefore, it is advisable not to save on this procedure, but to seek help exclusively from a competent specialist.

It is important to clarify that the histological examination is final, i.e., based on its results, the doctor prescribes the final treatment. If the answer is positive, individually selects an intensive care regimen; if negative, repeat biopsies are performed to clarify the diagnosis. Cytological examination, due to less information content, is an intermediate "link" in diagnosis. It is also considered mandatory. If the result is positive, this is the basis for an invasive histological examination.

results

When performing a histological examination, the result will be obtained after 4 to 14 days. When a quick response is needed, the biological material is immediately frozen after sampling, sections are made with their subsequent staining. In such a clinical picture, the result will be obtained after 40-60 minutes, but the procedure itself requires high professionalism on the part of a competent specialist. If the disease is confirmed, the doctor prescribes treatment, and what it will be - medication or surgery, depends entirely on medical indications, the specifics of the body.

As for the cytological examination, this is a faster, but less informative diagnostic method. The result can be obtained after 1 - 3 days from the moment of sampling of biological material. If it is positive, it is necessary to start oncology treatment in a timely manner. If negative, it will not be superfluous to perform a second biopsy. This is explained by the fact that doctors do not exclude errors, inaccuracies. The consequences for the body become fatal. Additionally, histology, gastroscopy (especially with damage to the digestive tract) and colonoscopy may be required.

Care after the fence

After a biopsy, the patient needs complete rest, which includes bed rest for at least the first day after the procedure, proper nutrition and emotional balance. At the site of the biopsy, the patient feels some soreness, which is less and less pronounced every day. This is a normal phenomenon, since part of the tissues and cells were deliberately injured by a medical instrument. Further postoperative measures depend on the type of procedure, the characteristics of the affected organism. So:

1. If a puncture was performed, additional suturing and bandaging is not necessary. With an increase in pain, the doctor recommends drinking an analgesic or using an ointment with an anesthetic effect externally.
2. When making incisions to take biological material, it may be necessary to apply a suture, which is removed after 4 to 8 days without serious consequences for the patient's health. Additionally, you will have to apply bandages, be sure to follow the rules of personal hygiene.

The recovery period should proceed under strict medical supervision. If the pain intensifies, purulent discharge or pronounced signs of inflammation appear, a secondary infection is not excluded. Such anomalies can equally occur with a biopsy of the bladder, mammary, pancreas or thyroid gland, and other internal organs. In any case, action is required immediately, otherwise the health consequences can be fatal.

Complications

Since such a surgical procedure is associated with a violation of the integrity of the skin, doctors do not exclude the addition of a secondary infection, followed by inflammation and suppuration. This is the most dangerous consequence for health, which can even turn into blood poisoning, exacerbation of other unpleasant diseases with periodic recurrence. So a temporary scar of different sizes at the site of direct biopsy sampling is not the only problem of an aesthetic nature, potential complications that are no longer dangerous to health can be as follows:

• profuse bleeding at the sampling site;
• acute pain syndrome in the diagnostic zone;
• internal discomfort after the end of the session;
• inflammatory process with high body temperature;
• injury to the organ under study (especially if a biopsy forceps is used);
• infection of the organ under study;
• septic shock;
• blood poisoning;
• suppuration at the puncture site;
• the spread of a bacterial infection with a fatal outcome.

What is a histological examination?

Histological examination- This is a morphological study of tissues, organs of a sick person, including a biopsy and examination of the surgical material. Biopsy is a morphological study of pieces of tissue taken from a patient for diagnostic purposes. Research of operational material- This is a morphological study of tissues, organs removed from a patient during a surgical operation performed for medicinal purposes. Histological or pathomorphological examination is the most important in the diagnosis of malignant tumors, one of the methods for evaluating drug treatment.

What are biopsies?

Biopsies can be external or internal. External biopsies- these are biopsies in which the material is taken directly under the "control of the eye". For example, biopsies of the skin, visible mucous membranes. Internal biopsies- these are biopsies in which pieces of tissue for research are obtained by special methods. So, a piece of tissue taken by puncture with a special needle is called needle biopsy taken by aspiration of a piece of tissue is called aspiration biopsies, by trepanation of bone tissue - trepanation. Biopsies obtained by excising a piece when dissecting superficially located tissues are called incisional, "open" biopsies. For morphological diagnosis are also used targeted biopsies, in which tissue sampling is performed under visual control using special optics or under ultrasound control.

Taking material for biopsy research should be carried out at the border with unchanged tissue and, if possible, with the underlying tissue. This primarily applies to external biopsies. Do not take pieces for biopsy from areas of necrosis or hemorrhage.

After sampling, the biopsy and surgical material should be immediately delivered to the laboratory, if delivery is delayed, it should be immediately fixed. The main fixative is a 10-12% formalin solution or 70% ethyl alcohol, while the volume of the fixing liquid should be at least 20-30 times the volume of the object being fixed. When sending for pathomorphological examination of the material, most often, tumor tissue, lymph nodes, before fixation, it is necessary to make a smear for cytological examination.

Depending on the timing of the biopsy response, there may be urgent ("express" or "cyto" biopsy), the answer to which is given in 20-25 minutes and planned, the answer to which is given in 5-10 days. Urgent biopsies are performed during surgery in order to resolve the issue of the nature and extent of surgery.

A pathomorphologist, conducting a study, produces a macroscopic description of the delivered material (size, color, consistency, characteristic changes, etc.), cuts out pieces for histological examination, indicating which histological methods should be used. Examining the manufactured histological preparations, the doctor describes the microscopic changes and conducts a clinical and anatomical analysis of the detected changes, as a result of which he makes a conclusion.

Biopsy results

The conclusion may contain an indicative or final diagnosis, in some cases only a “descriptive” answer. Estimated answer allows you to determine the range of diseases for differential diagnosis. Final diagnosis pathologist is the basis for formulating a clinical diagnosis. "Descriptive" answer, which can be with insufficient material, clinical information, sometimes allows us to make an assumption about the nature of the pathological process. In some cases, when the sent material turns out to be scarce, insufficient for a conclusion, while the pathological process could not get into the piece under study, the conclusion of the pathologist may be "false negative". In cases where the necessary clinical and laboratory information about the patient is missing or ignored, the response of the pathologist may be "false positive". In order to avoid "false-negative" and "false-positive" conclusions, it is necessary, together with the clinician, to conduct a thorough clinical and anatomical analysis of the detected changes with a discussion of the results of the clinical and morphological examination of the patient.

The cost of a biopsy in our medical center

s.d.- working day

Cannula for endometrial biopsy No. 3 is used to obtain material from the uterine cavity and its subsequent morphological examination. Used together with

• The cannula is made of flexible plastic; at the working end of the cannula there are two opposite openings.
• Each cannula is labeled to identify the location of the main opening. The first point is at a distance of 2 cm from the tip of the cannula; subsequent ones - at a distance of 1 cm from each other, in total - 12 cm.
• The cannula has a blue base and an adapter must be used to connect to it (adapters are included with the MBA syringe).
• Endometrial Biopsy Cannula No. 3 is for single use only.

Benefits of endometrial vacuum biopsy.

• Execution without prior dilatation of the cervix (Oehler MK, MacKenzie I, Kehoe S, et al., 2003).
• No need to use intravenous anesthesia, which can be replaced by paracervical anesthesia with 5 ml of 2% lidocaine (Seamark CJ., 1998).
• Endometrial biopsy is a cost-effective and safe procedure that is well tolerated by patients.
• Less risk of perforation than with a curette (Seamark CJ, 1998).
• - portable, and the #3 cannula is sterile and designed for individual use.
• Detection of endometrial carcinoma by MVA or other endometrial biopsy devices has been shown in a meta-analysis to be 99.6% in postmenopausal women and 91% in premenopausal women (Hui SK, Lee L, Ong C, et al. , 2006).
• In postmenopausal women, the combined use of biopsy specimens and ultrasonography has a high detection rate for endometrial carcinoma (Dijkhuizen FP, Mol BW, Brolmann HA, et al., 2000; Hill GA, Herbert CM, Parker RA, et al ., 1989).
• In the detection of endometrial pathology, such as polyps and submucosal nodes of uterine fibroids, endometrial biopsy is less effective (Dijkhuizen FP, Mol BW, Brolmann HA, et al., 2000).
• Vacuum endometrial biopsy is highly effective in diagnosing endometrial pathology in premenopausal patients with abnormal uterine bleeding (Van den Bosch T, Vandendael A, Van Schoubroeck D, et al., 1995).
• After the end of the manipulation, the aspirated material is squeezed out of the syringe into the fixative solution and sent for examination.

Endometrial biopsy instead of WFD.

A mandatory method for diagnosing various pathological conditions of the endometrium is its morphological study. Traditionally, obtaining samples of the endometrium for this was performed by the method of separate diagnostic curettage of the uterine cavity (RDV). However, the implementation of the EFD requires hospitalization of the patient, intravenous anesthesia and dilatation of the cervix to 8 mm. All this increases the time from the moment the first signs of endometrial pathology (acyclic uterine bleeding) appear to the results and increases costs. In addition, cervical dilation and curettage, especially repeated ones, increase the risk of miscarriage and preterm pregnancy in women with reproductive plans.

The current state of diagnosis of endometrial pathology, in particular, uterine cancer, cannot be considered satisfactory (Yu.Yu. Tabakman, 2010). The reason for this is due to the long latent course of the disease, the long period from the clinical manifestation of the disease to the diagnosis and treatment - an average of 4.5 and 6 months, respectively. Yu.Yu. Tabakman emphasizes that RFE is a traumatic operation that does not meet the requirements of ablastic surgery. At the same time, curettage of the mucous membrane of the cervical canal does not contribute to clarifying the stage of cancer of the uterine body and is recognized as an unnecessary procedure according to the conclusion of the Oncological Group of the International Federation of Gynecologists and Obstetricians of the International Federation of Gynecologists and Obstetricians (FIGO), which is reflected in the 1988 morphological classification of endometrial cancer, recognized and used throughout the world.

Therefore, at present, endometrial vacuum biopsy has replaced the traditional WFD, which provides the same sensitivity in the detection of endometrial diseases (Dimitraki M, Tsikouras P, Bouchlariotou S, et al., 2011).

Hysteroscopy and endometrial biopsy are considered today as the "gold standard" for diagnosing intrauterine pathology, primarily to exclude precancerous lesions and endometrial cancer. The method is recommended for suspected endometrial pathology, the presence of risk factors for uterine cancer (obesity, polycystic ovary syndrome, diabetes mellitus, family history of colon cancer), in patients with abnormal uterine bleeding after 40 years. Preference is given to office hysteroscopy and aspiration biopsy as less traumatic and more economical procedures (Chernukha G.E., Nemova Yu.I., 2013).

Hysteroscopy allows visualization of the uterine cavity, and is indicated if targeted biopsy and removal of endometrial polyps are necessary, as well as resection of submucosal myomatous nodes.

“You need to take a biopsy” - many have heard this phrase from the attending physician. But why is it needed, what does this procedure give and how is it carried out?

concept

A biopsy is a diagnostic study that involves taking biomaterial from a suspicious area of ​​​​the body, for example, compaction, tumor formation, a long-term non-healing wound, etc.

This technique is considered the most effective and reliable among all those used in the diagnosis of oncological pathologies.

Photo of breast biopsy

• Thanks to the microscopic examination of the biopsy, it is possible to accurately determine the cytology of tissues, which provides complete information about the disease, its degree, etc.
• The use of a biopsy allows you to identify the pathological process at its earliest stage, which helps to avoid many complications.
• In addition, this diagnosis allows you to determine the extent of the upcoming operation in cancer patients.

The main task of a biopsy is to determine the nature and nature of pathology tissues. For a detailed diagnosis, a biopsy study is supplemented with X-ray water, immunological analysis, endoscopy, etc.

Kinds

Biomaterial sampling can be done in different ways.

1. - a technique for obtaining a biopsy using a special thick needle (trephine).
2. excisional biopsy - a type of diagnosis in which the entire organ or tumor is removed during surgery. It is considered a large-scale type of biopsy.
3. Puncture– This biopsy technique involves obtaining the necessary samples by puncture with a fine needle.
4. Incisional. Removal affects only a certain part of the organ or tumor and is carried out in the process of a full-fledged surgical operation.
5. stereotactic- a minimally invasive diagnostic method, the essence of which is to build a specialized access scheme to a specific suspicious area. Access coordinates are calculated based on the pre-scan.
6. Brush biopsy- a variant of the diagnostic procedure using a catheter, inside which a string with a brush is inserted, collecting a biopsy. This method is also called the brush method.
7. Fine needle aspiration biopsy- a minimally invasive method in which the material is taken using a special syringe that sucks the biomaterial from the tissues. The method is applicable only for cytological analysis, since only the cellular composition of the biopsy is determined.
8. Loopback biopsy - a biopsy is taken by excising pathological tissues. The desired biomaterial is cut off by a special loop (electrical or thermal).
9. Transthoracic biopsy is an invasive diagnostic method used to obtain biomaterial from the lungs. It is carried out through the chest in an open or puncture way. Manipulations are carried out under the supervision of a videothoracoscope or computed tomography.
10. Liquid biopsy is the latest technology for detecting tumor markers in liquid biopsy, blood, lymph, etc.
11. Radio wave. The procedure is carried out using specialized equipment - the Surgitron apparatus. The technique is gentle, does not cause complications.
12. open- this type of biopsy is carried out using open access to the tissues, the sample of which needs to be obtained.
13. Preskalennaya biopsy - a retroclavicular study in which the biopsy is taken from the supraclavicular lymph nodes and lipid tissues at the angle of the jugular and subclavian veins. The technique is used to detect pulmonary pathologies.

Why is a biopsy done?

A biopsy is indicated in cases where, after other diagnostic procedures, the results obtained are not enough to make an accurate diagnosis.

Usually, a biopsy is prescribed when detected to determine the nature and type of tissue formation.

Today, this diagnostic procedure is successfully used to diagnose many pathological conditions, even non-oncological ones, since in addition to malignancy, the method allows you to determine the degree of spread and severity, stage of development, etc.

The main indication is to study the nature of the tumor, however, often a biopsy is prescribed to monitor ongoing oncology treatment.

Today, it is possible to obtain a biopsy from almost any area of ​​the body, and the biopsy procedure can perform not only a diagnostic, but also a therapeutic mission, when the pathological focus is removed in the process of obtaining a biomaterial.

Contraindications

Despite all the usefulness and highly informative technique, a biopsy has its own contraindications:

• The presence of blood pathologies and problems associated with blood clotting;
• Intolerance to certain drugs;
• Chronic myocardial insufficiency;
• If there are alternative non-invasive diagnostic options with similar information content;
• If the patient refuses to undergo such a procedure in writing.

Material research methods

The resulting biomaterial or biopsy is subjected to further research, which takes place using microscopic technologies. Usually, biological tissues are sent for cytological or histological diagnostics.

Histological

Sending a biopsy for histology involves microscopic examination of tissue sections, which are placed in a specialized solution, then in paraffin, after which staining and sections are performed.

Staining is necessary so that the cells and their parts are better distinguished by microscopic examination, on the basis of which the doctor draws up a conclusion. The patient receives the results in 4-14 days.

Sometimes a histological examination needs to be done urgently. Then the biomaterial is taken during the operation, the biopsy is frozen, and then sections are made and stained in a similar way. The duration of such an analysis is no more than 40 minutes.

Doctors have a rather short period of time to determine the type of tumor, decide on the volume and methods of surgical treatment. Therefore, in such situations, urgent histology is practiced.

Cytological

If histology relied on the study of tissue sections, then it involves a detailed study of cellular structures. A similar technique is used if it is not possible to obtain a piece of tissue.

Such a diagnosis is carried out mainly in order to determine the nature of a particular formation - benign, malignant, inflammatory, reactive, precancerous, etc.

The resulting biopsy specimen is smeared on glass, and then microscopic examination is carried out.

Although cytological diagnosis is considered easier and faster, histology is still more reliable and accurate.

Training

Before a biopsy, the patient must undergo a laboratory study of blood and urine for the presence of various infections and inflammatory processes. In addition, magnetic resonance, ultrasound, X-ray diagnostics are carried out.

The doctor examines the picture of the disease and finds out whether the patient is taking medication.

It is very important to tell the doctor about the presence of pathologies of the blood coagulation system and allergies to drugs. If the procedure is planned to be carried out under anesthesia, then you can not eat and drink liquid for 8 hours before the biopsy is taken.

How is a biopsy done in certain organs and tissues?

Biomaterial sampling is carried out using general or local anesthesia, so the procedure is usually not accompanied by painful sensations.

The patient is placed on the couch or operating table in the position required by the specialist. Then proceed to the process of obtaining a biopsy. The total duration of the process is often several minutes, and with invasive methods it can be up to half an hour.

In gynecology

An indication for a biopsy in gynecological practice is the diagnosis of pathologies, and the vagina, ovaries, external organs of the reproductive system.

Such a diagnostic technique is decisive in the detection of precancerous, background and malignant formations.

Used in gynecology:

• Incisional biopsy - when scalpel excision of tissue is performed;
• Targeted biopsy - when all manipulations are controlled by extended hysteroscopy or colposcopy;
• Aspiration - when the biomaterial is obtained by aspiration;
• Laparoscopic biopsy - in this way, a biopsy is usually taken from the ovaries.

An endometrial biopsy is performed by means of a pipel biopsy, in which a special curette is used.

Intestines

A biopsy of the small and large intestines is performed in various ways:

• Puncture;
• Petlev;
• Trepanation - when the biopsy is taken using a sharp hollow tube;
• Shchipkov;
• incisional;
• Scarifying - when a biopsy is scraped off.

The specific choice of method is determined by the nature and location of the area under study, but most often they resort to colonoscopy with biopsy.

Pancreas

Biopsy material from the pancreas is obtained in several ways: fine-needle aspiration, laparoscopic, transduodenal, intraoperative, etc.

Indications for pancreatic biopsy is the need to determine the morphological changes in pancreatic cells, if present, and to identify other pathological processes.

muscles

If a doctor suspects that a patient has developed systemic connective tissue pathologies, which are usually accompanied by muscle damage, a biopsy of the muscle and muscle fascia will help determine the disease.

In addition, this procedure is performed in case of suspicion of the development of periarteritis nodosa, dermatopolymyositis, eosinophilic ascites, etc. Such a diagnosis is used with needles or in an open way.

Heart

Biopsy diagnostics of the myocardium helps to detect and confirm such pathologies as myocarditis, cardiomyopathy, ventricular arrhythmia of unknown etiology, as well as to identify the processes of rejection of the transplanted organ.

According to statistics, right ventricular biopsy is more often performed, while access to the organ is carried out through the jugular vein on the right, femoral or subclavian vein. All manipulations are controlled by fluoroscopy and ECG.

A catheter (biopt) is inserted into the vein, which is brought to the required site where the sample is to be obtained. On the bioptom, special tweezers are opened, which bite off a small piece of tissue. During the procedure, a special medication is given through the catheter to prevent thrombosis.

Bladder

Bladder biopsy in men and women is performed in two ways: cold and TUR biopsy.

The cold method involves transurethral cytoscopic penetration and biopsy sampling with special tweezers. A TUR biopsy involves removing the entire tumor down to healthy tissue. The purpose of such a biopsy is to remove all visible formations from the bladder walls and make an accurate diagnosis.

Blood

A biopsy of the bone marrow is performed in the case of malignant tumor pathologies of the blood like.

Also, a biopsy study of bone marrow tissue is indicated for iron deficiency, splenomegaly, thrombocytopenia and anemia.

With a needle, the doctor takes a certain amount of red bone marrow and a small bone sample. Sometimes the study is limited to obtaining only a bone tissue sample. The procedure is performed by aspiration method or trepanobiopsy.

Eyes

Examination of the tissues of the eye is necessary, in the presence of a tumor formation of a malignant origin. These tumors are common in children.

A biopsy helps to get a complete picture of the pathology and determine the extent of the tumor process. In the process of diagnosing retinoblastoma, an aspiration biopsy technique using vacuum extraction is used.

Bone

A bone biopsy is performed to detect either infectious processes. Usually, such manipulations are carried out percutaneously by puncture, with a thick or thin needle, or surgically.

Oral cavity

Biopsy examination of the oral cavity involves obtaining a biopsy from the larynx, tonsils, salivary glands, throat and gums. Such a diagnosis is prescribed when pathological formations of the jaw bones are detected, or, to determine salivary glandular pathologies, etc.

The procedure is usually performed by a facial surgeon. With a scalpel, he takes a part and the whole tumor. The whole procedure takes about a quarter of an hour. Soreness is observed when an anesthetic is injected, and there is no pain when taking a biopsy.

Analysis results

The results of biopsy diagnostics are considered normal if the patient does not show any cellular changes in the examined tissues.

Effects

The most common consequence of such a diagnosis is rapidly passing bleeding and pain at the site of the biopsy.

Moderately weak pain is experienced by about a third of patients after a biopsy.

Serious complications after a biopsy usually do not occur, although in rare cases, fatal consequences of a biopsy occur (1 in 10,000 cases).

Care after the procedure

With severe pain syndrome, analgesics can be used. Care of the puncture site or suture (depending on the type of procedure) may vary somewhat, but you can remove the bandage only a day after the biopsy, then you can take a shower.