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Cytological examination together with histopathological examination play an extremely important role in cancer pathology as a solid basis not only for the diagnosis of the disease but also for the treatment orientation and prognosis of the disease. The cytology test is a simple test, easy to perform, and is widely used in many cases.1. What is cytology?
Cytology (Cytology or Cytopathology) is a common and highly valued test. Cytological examination examines loose cells or clusters of cells mixed in the fluid that are visible under the microscope. Sometimes only a drop of blood or fluid is needed, as in the FNA test, but sometimes a whole bottle of pleural or abdominal fluid is needed.Take a cell sample, less fatigue, less complications and less expensive for the patient than histopathological biopsy.
In many cases, a biopsy is more accurate. However, for some cases, the accuracy is almost the same. Therefore, the choice of cytological tests or biopsy tests will depend on the doctor's opinion after considering many factors related to the type of disease and the diseased organ.
Tế bào biểu mô thận
2. Diagnostic methods and cytological testing procedures
2.1 Fine Needle Aspiration This is the most commonly used method. A needle and syringe are used to poke the tumor or lymph node to remove some of the tumor fluid. For tumors that are small or difficult to palpate, needle aspiration may be performed under ultrasound guidance. Tumor fluid is removed, smeared on a slide, fixed, stained and read on an optical microscope. Today, fine needle aspiration is also used on non-palpable lesions, that is, aspiration cells through three-dimensional positioning under the guidance of imaging such as:
Small needle aspiration breast tumor under mammography guidelines. Aspiration of thyroid tumors, liver tumors under ultrasound guidance Pulmonary puncture, deep intra-abdominal tumors under CT guidance The accuracy of this test can reach 90%.
2.2 Method of laminography The method of laminography is used in the following cases: The patient has nipple discharge, the tumor ruptures and ulcers. This method is simple but gives a low positive rate. For example, cytology by barometer for breast cancer patients through nipple fluid can only detect about 40-60% of cases. Immediate diagnosis: In the absence of cryosurgery, the physician applies a slide for cytological diagnosis.
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2.3 Specimen smear This method is mainly used in making vaginal smears, smearing on glass slides and then staining the slides for cytological diagnosis.
This method is very important for prevention and early detection of cervical cancer. Through the vaginal smear can detect non-specific inflammatory lesions; specific inflammatory lesions (fungal, flagellate, associated with viral infections); The cytologic abnormalities range from mild, such as insignificant cell changes, to low-grade intraepithelial lesions (mild dysplasia) to high-grade intraepithelial lesions (moderate dysplasia, severe dysplasia). , carcinoma in situ) and then invasive carcinoma.
2.4 Secretions Discharge into the cavities, natural tubes of the body:
sputum, pleural, peritoneal, pericardial, testicular membranes. The fluid was then centrifuged and used for cytology. In some cases of kidney tumor, bladder tumor with hematuria, urine collection was centrifuged to find foreign cells. Nipple discharge Using secretions for cytological diagnosis only detects about 40-50% of malignancies.
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3. Advantages and disadvantages of cytological methods
3.1 Advantages Quick diagnosis: Within 30-60 minutes a diagnosis can be made. High precision toxicity: For fine needle aspiration in specialized centers, the sensitivity can be achieved 0.85-0.9, specificity 0.9, positive predictive value 0.99. Simple: The technique of fine needle aspiration or centrifugation is very simple. Low cost: Only need syringe, cotton, alcohol, technician and cytologist. Few complications: Some rare complications such as hematoma, infection, pneumothorax... The histopathological type can be determined in some cases The cytological specimen can be used for immunohistochemical staining. Translate.
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3.2 Disadvantages False negatives due to:
Tumor necrosis, fibrous too much, so the presence of tumor cells is absent or very little. For example, lobular carcinoma of the breast is caused by fibrous proliferation of the stroma, so few tumor cells are usually obtained. The tumor is not taken: poke the needle out of the tumor. Because the characteristics of tumor cells are similar to healthy cells, it is easy to mistake and difficult to diagnose. Requires the person taking the specimen to have experience False positive due to the following reasons:
Due to atypical cellularity Cases after radiotherapy causing cell changes Experience of cytologists. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.
To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.
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