Squamous cells were found. Reactive changes in the cervical epithelium: diagnosis, treatment and prevention. Oral squamous cell carcinoma

Cervical cancer most often develops in the transformation zone, it is preceded by background processes and intraepithelial lesions (epithelial dysplasia), which can be located in small areas, so it is important that material is obtained from the entire surface of the cervix, especially from the junction of squamous and columnar epithelium . The number of altered cells in a smear varies, and if there are few of them, then the likelihood increases that pathological changes may be missed when viewing the specimen. For effective cytological examination it is necessary to consider:

• During preventive examinations, cytological smears should be taken from women, regardless of complaints, the presence or absence of changes in the mucous membrane. Cytological examination should be repeated at least once every three years;
• it is advisable to obtain smears no earlier than on the 5th day of the menstrual cycle and no later than 5 days before the expected start of menstruation;
• you cannot take material within 48 hours after sexual intercourse, use of lubricants, vinegar or Lugol’s solution, tampons or spermicides, douching, insertion of medications, suppositories, creams into the vagina, including creams for performing ultrasound examinations;
• pregnancy is not the best time for screening, as incorrect results are possible, but if you are not sure that the woman will come for examination after childbirth, it is better to take smears;
• for symptoms of acute infection, it is advisable to obtain smears for the purpose of examining and identifying pathological changes in the epithelium, the etiological agent; Cytological control is also necessary after treatment, but not earlier than 2 months. after completing the course.

Material from the cervix should be taken by a gynecologist or (during screening, preventive examination) by a well-trained nurse (midwife).

It is important that the smear contains material from the transformation zone, since about 90% of tumors come from the junction of the squamous and columnar epithelium and the transformation zone, and only 10% from the columnar epithelium of the cervical canal.

For diagnostic purposes, material is obtained separately from the ectocervix (vaginal portion of the cervix) and endocervix (cervical canal) using a spatula and a special brush (such as Cytobrush). When conducting a preventive examination, Cervex-Brush, various modifications of the Eyre spatula and other devices are used to obtain material simultaneously from the vaginal part of the cervix, the junction (transformation) zone and the cervical canal.

Before obtaining the material, the cervix is ​​exposed in “mirrors”; no additional manipulations are performed (the cervix is ​​not lubricated, mucus is not removed; if there is a lot of mucus, it is carefully removed with a cotton swab without pressing on the cervix). A brush (Eyre spatula) is inserted into the external os of the cervix, carefully guiding the central part of the device along the axis of the cervical canal. Next, its tip is rotated 360° (clockwise), thereby obtaining a sufficient number of cells from the ectocervix and from the transformation zone. The instrument is inserted very carefully, trying not to damage the cervix. Then the brush (spatula) is removed from the canal.

Preparation of drugs

Transfer of the sample to a glass slide (traditional smear) should occur quickly, without drying out or losing mucus and cells adhering to the instrument. Be sure to transfer the material to the glass on both sides with a spatula or brush.

If it is intended to prepare a thin-layer preparation using the liquid-based cytology method, the brush head is disconnected from the handle and placed in a container with a stabilizing solution.

Fixation of strokes performed depending on the intended staining method.

Papanicolaou and hematoxylin-eosin staining are the most informative in assessing changes in the cervical epithelium; any modification of the Romanovsky method is somewhat inferior to these methods, however, with experience, it allows one to correctly assess the nature of the pathological processes in the epithelium and the microflora.

The cellular composition of smears is represented by desquamated cells located on the surface of the epithelial layer. When adequate material is obtained from the surface of the mucous membrane of the cervix and from the cervical canal, the cells of the vaginal portion of the cervix (stratified squamous non-keratinizing epithelium), the junction or transformation zone (cylindrical and, in the presence of squamous metaplasia, metaplastic epithelium) and cells of the cervical canal enter the smear. columnar epithelium). Conventionally, cells of multilayered squamous non-keratinizing epithelium are usually divided into four types: superficial, intermediate, parabasal, basal. The better the epithelium’s ability to mature, the more mature cells appear in the smear. With atrophic changes, less mature cells are located on the surface of the epithelial layer.

Interpretation of cytological examination results

The most common at present is the Bethesda classification (The Bethesda System), developed in the USA in 1988, to which several changes have been made. The classification was created to more effectively transfer information from the laboratory to clinical doctors and ensure standardization of treatment of diagnosed disorders, as well as follow-up of patients.

The Bethesda classification distinguishes squamous intraepithelial lesions of low grade and high grade (LSIL and HSIL) and invasive cancer. Low-grade squamous intraepithelial lesions include changes associated with human papillomavirus infection and mild dysplasia (CIN I), high-grade - moderate dysplasia (CIN II), severe dysplasia (CIN III) and intraepithelial carcinoma (cr in situ). This classification also contains indications of specific infectious agents that cause sexually transmitted diseases.

To designate cellular changes that are difficult to differentiate between reactive states and dysplasia, the term ASCUS - atypical squamous cells of undetermined significance (squamous epithelial cells with atypia of unclear significance) has been proposed. For a clinician, this term is not very informative, but it directs the doctor to the fact that this patient needs examination and/or dynamic monitoring. The Bethesda classification has now also introduced the term NILM – no intraepithelial lesion or malignancy, which combines normal, benign changes, and reactive changes.

Since these classifications are used in the practice of a cytologist, below are parallels between the Bethesda classification and the classification common in Russia (Table 22). Cytological standardized report on material from the cervix (form No. 446/u), approved by order of the Ministry of Health of Russia dated April 24, 2003 No. 174.

The reasons for receiving defective material are different, so the cytologist lists the types of cells found in the smears and, if possible, indicates the reason why the material was considered defective.

The mucous membranes of the female genitourinary system consist of squamous epithelium. Columnar epithelium is also found and lines the cervical canal. Its cells secrete a certain secretion and help protect the mucous membrane of the organ from external damage. Columnar epithelium in a smear below or above normal may indicate a disruption in the woman’s hormonal background or the presence of inflammation.

The function of the columnar epithelium is to provide the necessary amount for its lubrication. In the normal state, the cells of such epithelium are dispersed over the surface of the cervical canal in groups that have the shape of honeycombs, stripes or glasses. The latter depends on the stretching of the cytoplasm by mucus.

Deviations from the norm and consequences:

• the displacement of columnar epithelium and its replacement of flat cells says;
• a low number of columnar epithelial cells indicates hormonal imbalance;
• a lot of atypical columnar epithelium - this is the development of cancer pathologies in the cervix;
• an increase in atypical cylindrical cells may indicate infectious diseases of the woman’s genitourinary system, in particular the urethra, the presence of inflammatory processes (erosion);
• post-traumatic disorders - formation of fistulas in the vaginal and cervical area.
• the absence of columnar epithelium in the smear may indicate the death of its cells, which is a prerequisite for the development of cervical dysplasia.

Important! Intensive proliferation of atypical cells, both cylindrical and may indicate the development of benign mastopathy. Negative pathological processes in a woman’s mammary glands can provoke changes in the mucous membranes of the genitourinary system.

Factors influencing the number of cells in the mucous layer of the reproductive organs

Basically, all organs in the human body are lined with squamous epithelial cells. Among them there is also cylindrical epithelium, which is mostly located in the cervical canal. Its main function is secretory. The presence of such a layer is responsible for the formation of a barrier to the negative influences of the external environment.

Reasons for changes in the amount of columnar epithelium in a woman’s smear:

1. The presence of infections in the genital organs that cause inflammatory processes. This can be the entry into the body of gardnerella, streptococci, chlamydia. The formation of atypical columnar epithelial cells can also be affected by the human papillomavirus.
2. Trauma to the cervix as a result of difficult childbirth, curettage during abortion and other disorders of the epithelial layer.
3. Hormonal imbalances are triggered by an increase in the level of estrogen in the blood. At this time, the replacement of squamous epithelium with cylindrical epithelium is provoked by the occurrence of diseases such as papillomas, endometriosis, fibroma, ovarian dysfunction, and disturbances in the menstrual cycle.
4. A woman's weakened immune system.
5. Early sexual activity. The pathological proliferation of cylindrical cells can be provoked by early sexual acts, during which the unformed epithelial layer could be damaged.
6. An active sex life, which is accompanied by a constant change of sexual partners.

Note! Pathological changes in the columnar epithelium are almost always accompanied by some signs. Their presence should encourage women to consult a specialist.

Symptoms of the development of pathological changes in the mucous membranes

An increase in the amount of columnar epithelium in the flesh, until it replaces flat cells, in an advanced form causes a certain discomfort in the genitourinary system, which a woman cannot help but notice. Any more negative manifestations indicate the presence of pathological changes in the reproductive organs.

The main symptoms of changes in the columnar epithelium:

• The presence of copious discharge with the appearance of an odor, which is accompanied by itching or burning.
• The appearance of pain during intimate relationships, as well as the presence of bloody leucorrhoea after.
• Disturbances in the menstrual cycle that provoke long-term infertility.

Important! In the early stages, minor deviations in the smear do not have obvious signs. That is, in this case, the doctor can detect any violations only during the next gynecological examination by taking a smear for the flora.

Diagnosis of the disease and methods of treatment

Detection of a particular disease of the genitourinary system begins with a gynecological examination and taking a smear. Such an analysis makes it possible to identify the presence and quantity of both squamous and columnar epithelium, detect leukocytes that indicate inflammatory processes and prescribe further clarifying examination.

Normally, the cylindrical epithelium in a woman’s smear should contain no more than 4–15 cells that fall into the field of view. Exceeding the norm indicates the presence of pathology in the cervical canal and uterus. If there are very few cells, then we are talking about hormonal imbalances. The complete absence of epithelial cells may indicate cervical dystrophy and cause infertility.

Carrying out an analysis by taking a smear from the uterus and its canal makes it possible to determine the presence of atypical cells in the mucous membranes of the reproductive organs. Their presence indicates that malignant pathologies are developing in the cervical canal. A smear in which a large number of atypical columnar epithelial cells indicates a precancerous or cancerous condition.

If, after examining the smear, a significant replacement of the squamous epithelium with cylindrical epithelium was revealed, then the patient may be prescribed other methods of examination - cytological studies, bacterial cultures based on the smear, hormonal background, immunogram.

The mucous membranes of the female genitourinary system consist of squamous epithelium. Columnar epithelium is also found and lines the cervical canal. Its cells secrete a certain secretion and help protect the mucous membrane of the organ from external damage. Columnar epithelium in a smear below or above normal may indicate a disruption in the woman’s hormonal background or the presence of inflammation.

The essence of columnar epithelium, possible deviations from the norm

The function of the columnar epithelium is to provide the necessary amount of mucus in the cervix for its lubrication. In the normal state, the cells of such epithelium are dispersed over the surface of the cervical canal in groups that have the shape of honeycombs, stripes or glasses. The latter depends on the stretching of the cytoplasm by mucus.

Deviations from the norm and consequences:

• displacement of the columnar epithelium and its replacement of flat cells indicates the presence of a pathology such as ectopia;
• a low number of columnar epithelial cells indicates hormonal imbalance;
• a lot of atypical columnar epithelium - this is the development of cancer pathologies in the cervix;
• an increase in atypical cylindrical cells may indicate infectious diseases of the woman’s genitourinary system, in particular the urethra, the presence of inflammatory processes (cervicitis, erosion);
• post-traumatic disorders - formation of fistulas in the vagina and cervix, ectropion, scar processes.
• the absence of columnar epithelium in the smear may indicate the death of its cells, which is a prerequisite for the development of cervical dysplasia.

Important! Intense proliferation of atypical cells of both cylindrical and squamous epithelium may indicate the development of benign mastopathy. Negative pathological processes in a woman’s mammary glands can provoke changes in the mucous membranes of the genitourinary system.

Factors influencing the number of cells in the mucous layer of the reproductive organs

Basically, all organs in the human body are lined with squamous epithelial cells. Among them there is also cylindrical epithelium, which is mostly located in the cervical canal. Its main function is secretory. The presence of such a layer is responsible for the formation of a barrier to the negative influences of the external environment.

Reasons for changes in the amount of columnar epithelium in a woman’s smear:

1. The presence of infections in the genital organs that cause inflammatory processes. This can be the entry into the body of gardnerella, streptococci, chlamydia. The formation of atypical columnar epithelial cells can also be affected by the human papillomavirus.
2. Trauma to the cervix as a result of difficult childbirth, curettage during abortion and other disorders of the epithelial layer.
3. Hormonal imbalances are triggered by an increase in the level of estrogen in the blood. At this time, the replacement of squamous epithelium with cylindrical epithelium is provoked by the occurrence of diseases such as papillomas, endometriosis, fibroma, ovarian dysfunction, and disturbances in the menstrual cycle.
4. A woman's weakened immune system.
5. Early sexual activity. The pathological proliferation of cylindrical cells can be provoked by early sexual acts, during which the unformed epithelial layer could be damaged.
6. An active sex life, which is accompanied by a constant change of sexual partners.

Note! Pathological changes in the columnar epithelium are almost always accompanied by some signs. Their presence should encourage women to consult a specialist.

Symptoms of the development of pathological changes in the mucous membranes

An increase in the amount of columnar epithelium in the flesh, until it replaces flat cells, in an advanced form causes a certain discomfort in the genitourinary system, which a woman cannot help but notice. Any more negative manifestations indicate the presence of pathological changes in the reproductive organs.

The main symptoms of changes in the columnar epithelium:

• The presence of copious discharge with the appearance of an odor, which is accompanied by itching or burning.
• The appearance of pain during intimate relationships, as well as the presence of bloody leucorrhoea after.
• Disturbances in the menstrual cycle that provoke long-term infertility.

Important! In the early stages, minor deviations in the smear do not have obvious signs. That is, in this case, the doctor can detect any violations only during the next gynecological examination by taking a smear for the flora.

Diagnosis of the disease and methods of treatment

Detection of a particular disease of the genitourinary system begins with a gynecological examination and taking a smear. Such an analysis makes it possible to identify the presence and quantity of both squamous and columnar epithelium, detect leukocytes that indicate inflammatory processes and prescribe further clarifying examination.

Normally, the cylindrical epithelium in a woman’s smear should contain no more than 4–15 cells that fall into the field of view. Exceeding the norm indicates the presence of pathology in the cervical canal and uterus. If there are very few cells, then we are talking about hormonal imbalances. The complete absence of epithelial cells may indicate cervical dystrophy and cause infertility.

Carrying out an analysis by taking a smear from the uterus and its canal makes it possible to determine the presence of atypical cells in the mucous membranes of the reproductive organs. Their presence indicates that malignant pathologies are developing in the cervical canal. A smear in which a large number of atypical columnar epithelial cells indicates a precancerous or cancerous condition.

If, after examining the smear, a significant replacement of the squamous epithelium with cylindrical epithelium was revealed, then the patient may be prescribed other methods of examination - cytological studies, bacterial cultures based on the smear, hormonal background, immunogram.

Important! After a special examination of the affected area and identification of atypical columnar epithelial cells, a biopsy may be prescribed.

After a woman has been diagnosed and the cause of the abnormal columnar epithelium in the smear has been identified, the woman is prescribed appropriate treatment. Therapy is based on drug treatment, which includes anti-inflammatory drugs, drugs that eliminate infection in the genitals. At this time, doctors try to normalize hormonal levels and strengthen the body's defenses.

The presence of cylindrical or squamous epithelium in a smear above or below the norm always indicates the development of negative abnormalities in the genitourinary system. If a woman experiences discomfort in the form of pain, burning, itching and pathological discharge, then diagnosis and treatment are urgently needed. Otherwise, untimely detection of pathology can lead to serious consequences, and self-medication will only aggravate the condition of the body.

vseomatke.ru

Flat epithelium in a cytology smear - what does it mean?

Almost every woman knows that squamous epithelium in a smear is a very important indicator with which a doctor can determine the condition of the mucous layer of the genital organs.

Cytology analysis provides reliable information about the hormonal background, as well as the presence or absence of a pathological process in the genitourinary system.

What is squamous epithelium?

Very often, patients ask the question of whether squamous epithelial cells should be present in the smear and how many of them there should be, after receiving the result of the cytology analysis.

Some women are scared when they see the presence of epithelial cells in the results. There's really no need to worry.

The flat epithelium in a smear does not pose any danger, of course, if this indicator is normal.

The presence of squamous epithelial cells is physiologically justified. This cover protects all fabric surfaces. There are flat and columnar epithelium.

Depending on the load that the tissue experiences, the integumentary cells have different structures. For example, the skin is covered with multilayered epithelium, which tends to keratinize.

The inner surface of the vagina and the outer part of the cervix are also lined with several layers of cells.

Simply put, squamous epithelium is a covering that forms the mucous layer of internal organs (vagina, cervix and others).

The epithelial layer consists of superficial, basal and intermediate cells. Every six to seven days (as it matures), the young layer changes its cellular shape and size.

The outdated particles are peeled off and replaced with new ones, so squamous epithelium should be present in smears of healthy women.

Due to the formation of new cells, the thickness of the mucous membrane increases. It should be noted that squamous epithelium consists of elements with small nuclei and abundant cytoplasm.

The gynecologist attaches great importance to the results of the analysis. When deciphering, the doctor analyzes the condition of the genital organs and draws conclusions about the presence or absence of hormonal imbalance.

An insufficient number or a significant increase in the cells that form the mucous layer indicates diseases of the body that can lead to the formation of tumors.

The presence of epithelial particles in the smear may indicate vaginitis, urethritis, a lack or excess of certain hormones. Only an analysis will tell you whether such cells are dangerous or not.

The epithelial cover contains cells that make up the intermediate layer. The thickness of the squamous epithelium is one hundred fifty to two hundred microns.

In addition, the smear may contain cylindrical epithelial cells that line the internal os and partially the cervical canal.

The covering provides the necessary amount of mucus to lubricate the cervix. The indicator of cylindrical epithelial cells should also correspond to the norm.

Why is a smear necessary?

Most women pay their visit to the gynecologist with some constraint, modesty or even hostility.

Avoiding troubles for women in terms of health is quite simple.

It is enough to regularly take a cytology test, the results of which can provide answers to many questions. A smear can tell about the presence of not only bacteria, fungi or leukocytes.

The result of the smear analysis will help determine the number of epithelial cells and promptly identify inflammatory (sometimes even cancerous or precancerous) processes in a woman.

The gynecologist definitely recommends taking a cytology test (PAP test) at least once a year. When planning a pregnancy, this analysis is inevitable.

It is very important to get the result of a smear for pregnant women who did not have time to take it in the process of planning a future child.

During pregnancy, the flat epithelium that lines the vagina is capable of retaining harmful microorganisms.

By detecting an increased number of epithelial cells in time, the doctor will help avoid the development of a severe inflammatory process in the expectant mother. Lack of estrogen in a pregnant woman can be easily diagnosed by a low level of squamous epithelium.

Experts prescribe this test to women who want to have an intrauterine device installed, if they suspect the presence of genital herpes, in cases of infertility or menstrual irregularities.

Patients who are overweight (obese) may have gynecological disorders, and the doctor also often recommends a smear test.

The best time to conduct the study is the fourth or fifth day of the cycle. Before taking the test, a woman should abstain from sexual intercourse for at least two or three days, avoid the use of ointments, lubricants, and douching.

You need to stop going to the toilet two to three hours before visiting the gynecologist. Before this, you first need to do a hygienic wash.

A smear is taken from women during a gynecological examination using a special small disposable brush. The material is carefully taken from the surface of the cervix.

The procedure is painless, but at the time of taking the scraping, slightly unpleasant sensations may occur.

After the doctor takes the material for analysis, some women may experience slight spotting. This is a normal phenomenon, the patient should not be afraid of this.

Normal squamous epithelium in a smear

The microbial composition of the smear is determined by specialists in laboratory conditions. With the help of special reagents, the epithelium in the scraping is painted in different colors, with the help of which you can designate and evaluate the composition of the material taken for analysis.

The results of the smear are usually known within one day. When all particles of squamous epithelium have the correct shape and size, the analysis is considered normal. There must be no atypical cells.

If particles with pathology are detected, the doctor should prescribe additional studies of the reasons for their appearance.

As a result of the analysis, a woman may see the abbreviation “Ep”, which means epithelium. In a smear, the normal number of squamous epithelial particles is about fifteen pieces.

A deviation in any direction indicates that some local pathologies are developing in the woman’s body that threaten her health. If the result of the presence of squamous epithelium is overestimated, then the patient may exhibit inflammatory processes.

A woman of childbearing age with an increased deviation from the norm in a smear may suffer from infertility. Often, an increase in the amount of squamous epithelium indicates the presence of vaginitis.

Patients often visit a gynecologist with complaints of itching in the vaginal area, the presence of copious unpleasant discharge, sometimes with a characteristic odor.

In such cases, the doctor prescribes appropriate antibacterial drugs. To avoid re-infection, it is recommended that the sexual partner of the sick patient also undergo examination.

A situation in which the amount of squamous epithelium in a scraping is significantly higher than normal may be a sign that a woman has gardnerella, trichomonas, gonococcus and other pathogens.

One of the reasons for the presence of a large number of epithelial cells in a smear may be estrogens.

Excessive saturation of the body with hormones of this group can lead to termination of pregnancy.

An underestimated amount of squamous epithelium in a smear is also an alarming symptom, since it indicates thinning of the vaginal mucous membranes.

Experts attribute the decrease in the indicator to estrogen deficiency in the patient. Women, as a rule, note an almost complete absence of discharge.

During sex, an insufficient amount of lubrication is produced, which makes sexual intercourse much more difficult. A small number of epithelial cells usually alerts doctors.

There is an assumption that a woman with this result has a tendency to develop cancerous tumors.

Timely diagnosis of deviations from the norm will help to avoid the further development of a large number of diseases in women. Do not neglect visiting a gynecologist.

At the slightest discomfort, a woman should try to visit a doctor as soon as possible and take a cytology test.

It should be noted that after proper treatment, the squamous epithelium in the scraping often takes on normal values.

moydiagnos.ru

Squamous epithelial cells in a smear for cytology: when does this indicate the presence of abnormalities in the body?

The rather complex process of diagnosing infections of the genital organs and genitourinary system most often does not allow the doctor to quickly and promptly prescribe the necessary treatment.

This is especially true for oncological diseases that are asymptomatic. Therefore, women of reproductive age are recommended to take a cytology test at least once a year.

Cytological smear: what is it?

The cytological smear also has other names, such as Pap test, cytology smear, Pap smear. This type of study is carried out during a gynecological examination, as a result of which the doctor suspects an anomaly. To carry out the test, it is necessary to collect cells with a special instrument, a brush, from the walls of the vagina, from the cervical canal, and also from the cervix.

The procedure is carried out without special preparation and is painless for the patient. The resulting mucus is applied to a glass slide, dried and sent for examination. During the analysis, the drug is stained with special reagents and examined under a microscope. This determines:

• structures and sizes of cells;
• epithelium shape;
• number of cells per unit area;
• pathologies in cell structure;
• arrangement of cells relative to others.

A cytology smear allows you to determine the presence of inflammation of the genitourinary system, the development of tumors and the likelihood of developing precancerous epithelial pathologies. Squamous epithelium is a layer of cells lining the vaginal mucosa.

The upper layer of the mucosa consists of keratinized and non-keratinized cells. It is the presence of a large number of keratinized cells in the smear that can tell the doctor about diseases.

After taking a smear, a small amount of bloody discharge is allowed for three days. If a woman’s condition worsens and her temperature rises, heavy bleeding, abdominal pain, and chills occur, she should immediately consult a doctor.

Normal squamous epithelial cells

The presence of squamous epithelial cells in the smear is normal, since the entire cervix is ​​covered with squamous epithelium. The normal volume of these cells in a smear can be up to 15 units per field of view. The absence or greater volume of cells indicates the presence of abnormalities in the body. However, an accurate diagnosis can only be established by assessing all study parameters. A small number of squamous epithelial cells in a Pap smear (up to 5 per field of view) indicates insufficient production of estrogen in a woman’s body.

In medical practice, there have been cases when there are no squamous epithelial cells in a Pap smear. This indicates that they are atrophied. In addition, such cell death may indicate a high likelihood of developing cancer. In this situation, in addition to the usual cytology test, the doctor recommends that the woman undergo additional tests to obtain more accurate results.

Converse research results or an excessive increase in the number of squamous epithelial cells in a cytology smear (from 15 or higher in the field of view) is most often a sign of cervical inflammation, diffuse mastopathy or primary infertility. If there are benign formations in the genitourinary system or during hyperkeratosis, an increased number of squamous epithelial cells may also be observed. Hyperkeratosis is a disorder of the keratinization process in the body. At the same time, the amount of squamous epithelium produced in the body is not controlled.

In addition to the number of squamous epithelial cells in the smear, the size and condition of the cells are also studied. All these data are evaluated to obtain accurate information about the woman's health.

The size and general condition of flat cells is studied according to indicators such as:

• form;
• structure;
• sizes.

Indicators consisting not only of flat epithelial cells, but also cylindrical and multilayered ones are considered normal. Such research results can be observed if the smear collection procedure is not entirely accurate. Then cells from different layers of the epithelium enter it. However, the presence of cells with an abnormal structure in the smear may indicate that inflammatory processes are occurring in the uterus, including a high probability of the presence of papillomavirus, benign lesions of the cervix or dysplasia in the woman’s body.

Only a doctor can evaluate the results of the study and make a preliminary diagnosis based on the analysis.

Epithelial cells with and without atypia

Atypia is a special condition of cells. They have an incorrect structure, and their shape, structure and dimensions are changed. This condition is one of the main signs of pathologies, including a high probability of developing cancer, since an atypical cell is a potential cell from which a tumor can form.

If atypical cells are present in a cytology smear, it is usually assumed that a woman has developed HPV, vaginal infections, or the process of degeneration of epithelial cells into squamous cell carcinoma.

Normally, atypical cells are not found in cytological studies. A PAP test is used to detect them. Based on its results, the severity of atypia is calculated. There are 5 classifications in total.

In case of normal cytology in a person, his analysis is assigned the first class.

If there is a slight change in the morphological structure of the cells that were affected by inflammation occurring in the body of the uterus or vagina, the tests receive a second class with an explanation, that is, what disease could cause atypia. This could be inflammation, tumor, condylomas, HPV.

The third class requires a repeat examination, since the smear taken reveals cells with uncharacteristic abnormalities of the nucleus and cytoplasm. Dysplasia of several types can be observed: mild, moderate or pronounced.

The fourth class assumes the presence in the analyzes of cells with an uncharacteristic enlarged nucleus of a non-standard shape, while its cytoplasm is also changed and signs of malignancy are observed.

The fifth class is the study results in which the number of malignant squamous epithelial cells is significantly higher. In this case, invasive cancer is diagnosed.

If the study does not reveal atypical cells, then the diagnosis is established solely by measuring their number in the smear.

Cytological nasal smear

A cytological smear is prescribed for women not only if there is a risk of diseases of the genitourinary system. Quite often, this type of research is prescribed for studies of the nasal mucosa.

However, such an analysis is called a nasocytogram. Its task is also to study epithelial cells, as well as neutrophils, lymphocytes, monocytes, mast and plasma cells, and eosinophils. In addition, the characteristics of these cells are studied.

A nasal smear for cytology is carried out as follows. A special brush is used to collect epithelial cells from the lower nasal passage. In this case, the analysis is taken from both nostrils, so the left and right halves of the nose are examined separately.

When evaluating the test, the quality and quantity of the cells obtained, as well as their composition, and possible signs of intracellular infections are studied. It is also important to count different types of cells in order to obtain comparative data that allows us to identify different diseases.

Nasocytogram indicators are considered normal in which a person’s smear shows a single number of neutrophils, single lymphoid elements, single eosinophils, a small number of anucleate cells of squamous epithelium, squamous epithelial cells themselves (up to 2% of the total cell volume), columnar epithelium.

Depending on the disease, the results of the study may show other results, according to which the doctor will be able to assess the patient’s health status and, if necessary, prescribe other studies to confirm the disease.

medickon.com

Columnar epithelium in a smear: normal and possible deviations

When analyzing samples from the vagina, columnar epithelium in the smear must be present in a strictly defined quantity.

If this parameter is violated, the woman should undergo a more in-depth examination, since the cause of low or high content of columnar epithelium in the smear can be dangerous inflammatory diseases, including sexually transmitted infections.

Purpose and structure

Epithelial or border tissue lines all surfaces and cavities of the body, including the genitourinary tract. The vaginal epithelium is represented by two types of cells - flat and cylindrical.

Most of the vagina is lined with flat epithelium; the cylindrical epithelium is located on the surface of the cervical canal, and does not line the opening with a continuous layer, but is located in small groups or strips.

Endocervix is ​​a passage in the cervix connecting the uterine cavity to the vagina. Normally, it should be lined with cylindrical tissue, the cells of which produce a thick secretion.

A smear taken from the endocervix may also contain squamous epithelial cells.

Columnar epithelium can be single-layered or multilayered. Single layer covers the gastric mucosa.

In the vagina, cylindrical tissue lies on a special formation - the basement membrane, which helps maintain the architecture of the epithelial tissue and ensures its connection with the underlying connective tissue.

The main function of the columnar epithelium is to secrete a mucous secretion, which then spreads throughout the vagina and protects its surface from microtrauma.

What does columnar epithelium look like in a smear? Columnar epithelial cells in a smear are located, as a rule, in the form of groups and clusters.

If you look at the epithelium from the side, you will see that its cells are arranged in regular rows and have different shapes - from highly cylindrical to cuboidal.

The nucleus is always shifted to the basal edge, round or oval, the chromatin structure is uniform.

The cytoplasm is weakly colored, pink grains or uniform pink coloring may be observed - these are signs of secretion. There are cells with cilia in the apical part.

The columnar epithelium changes depending on the phase of the ovarian-menstrual cycle. During the proliferative phase, the nuclei are located at the base of the cells. In the secretory phase, the cells will be the most elongated, with the nuclei moving to the center.

Under the cylindrical epithelium on the basement membrane there are reserve cells that, depending on various factors, can be transformed into both flat and cylindrical.

Reserve cells are round-shaped particles with pale cytoplasm and a huge nucleus, occupying almost the entire volume.

Areas in which squamous and columnar epithelium can replace each other are called transformation zones.

The location of such zones depends on the woman’s age. In young nulliparous women, the transformation zone is located on the ectocervix. As it grows older, it moves to the level of the external pharynx.

Norms and deviations

The number of cylindrical cells in the discharge is influenced by various factors: cycle phase, age, treatment with hormonal drugs.

Normally, the amount of columnar epithelium in a smear in a woman of reproductive age does not exceed 3–15 cells in the viewing area.

The results of the smear can be affected by hygiene and treatment with hormonal pharmaceuticals, including suppositories and ointments.

Deviation from the norm of the cylindrical epithelium in the smear may indicate the following pathologies:

• ectopia - replacement of cylindrical cells with flat ones;
• a decrease in the number of cylindrical cells in a smear indicates a hormonal imbalance;
• excess cylindrical tissue in a smear is a symptom of cancerous pathologies of the cervix, inflammatory diseases of the urethra and vagina, inflammation of the cervix and cervical canal;
• the complete absence of tubular cells in the smear indicates dysplasia.

The cylindrical tissue contains glands that actively produce secretions, which accumulate in the form of a plug in the cervical canal and protect the uterine cavity from the penetration of microorganisms from the vagina.

Interesting: cervical mucus prevents the penetration of microorganisms into the uterus, but is not a barrier to sperm.

Normally, tubular tissue should be located only in the opening of the cervix and not extend beyond it. That is, the gynecologist should not see the columnar epithelium through a colposcope or mirror.

A healthy woman has exactly this cervical anatomy. If a gynecologist, looking into a gynecological speculum, discovers that outside the canal there is a cylindrical epithelium, which looks looser, brighter and juicier than flat, then the woman is diagnosed with “ectopia” or, as they used to say, “erosion”.

Tubular cells are more traumatic than flat cells. In vaginal conditions, they are damaged by the acidic environment and microorganisms.

Delicate tissue cannot exist normally in vaginal conditions that are unsuitable for it, and constant trauma can lead to more severe diseases than erosion.

Treatment of ectopia involves removing cylindrical tissue from the wrong places. Destruction is carried out with a mixture of weak acids, radio wave method, laser, cryodestruction, electric current. Subsequently, flat cells will grow in place of the destroyed tubular cells.

Causes and symptoms of abnormal smears

Cervical ectopia is very common. Its exact reasons are not known. Externally, ectopia is expressed by a shift of the mucous membrane of the endocervix outward, and not only the cells of the columnar epithelium are displaced, but also the internal layers of the cervix.

Ectopia can be diagnosed using a five percent solution of acetic acid, which is used to treat the cervix, after which white spots of tubular epithelium become visible on the surface. The phenomenon is explained by the swelling or coagulation of proteins under the influence of vinegar.

Ectopia can develop even in newborns and adolescents.

During the reproductive period, the dividing line between the zones with tubular and flat cells extends to the outer edge of the cervix, where it can be clearly seen in the colposcope.

A small ectopia in most cases is an absolutely physiological phenomenon, but an extensive one leads to the appearance of inflammation and leucorrhoea, and can become the background for malignant degeneration.

In addition to ectopia, the cause of the appearance of an increased number of tubular cells in a smear can be diseases of the urinary and reproductive sphere.

The main reasons for changes in the number of tubular cells in a smear:

• an infectious process in the genitals, accompanied by inflammatory phenomena (chlamydia, papillomavirus, streptococci, gardnerella);
• damage to the uterine cervix during childbirth, abortion, surgery;
• a sharp increase in the female hormone estrogen, accompanied by endometriosis, ovarian dysfunction, fibrosis;
• low immune defense of the whole body;
• early onset of sexual life;
• frequent change of sexual partners.

During menopause, noticeable atrophy of the integumentary tissue is observed, especially in the area of ​​the cyst. The appearance of a large amount of epithelium in a smear can be a symptom of benign mastopathy, since the mammary glands and reproductive organs are controlled by the same hormones.

Changes in the integumentary tissue may be accompanied by external symptoms: an increase in the volume of discharge, itching, pain during sex; menstrual irregularities.

Abnormalities of cylindrical tissue can be detected in the early stages only with a smear or gynecological visual examination.

If a large number of abnormal particles are found in the smear, the doctor may suspect a precancerous or cancerous condition. In this case, the examination will have to be continued by undergoing a biopsy.

So, normally, the tubular epithelium should be located only inside the cervix. Its appearance on the surface of the cervix, and even more so on the walls of the vagina, is considered a pathology caused by infections or hormonal diseases.

A smear taken from the cervix should contain 4–15 particles of tubular epithelium in one viewing sector.

More abundant content indicates erosion and other diseases leading to the growth of cylindrical tissue.

Squamous epithelium in a smear is a medical concept used by doctors who study the health of the reproductive system of women and men. Identification of epithelial cells in biomaterial is carried out in the laboratory, and their number can tell a specialist both about the normal state of the genital area and about various pathological processes occurring inside and outside the human body. To obtain such information, a person must undergo a cytology smear, which is often called a microflora smear.

What is squamous epithelium?

For a gynecologist or urologist, the flat epithelium in a smear for microflora is an important source of information, even though the doctor himself cannot examine these microparticles when taking a smear. Cells and layers of epithelium are detected during the study of biomaterial taken from the surface of the cervical canal and from the walls of the vagina in women or from the urethra in men under a microscope.

Almost our entire body is covered with some kind of protective shell, which we call skin. But the skin in the mouth, around the eyeball, in the vagina, in the urethral canal, etc. is somewhat different because it is not made of such durable material. Such delicate skin, covered with mucous secretions, is usually called the mucous membrane, and its surface layer, which covers the epidermis, is called epithelium.

Despite the fact that the mucous membrane is abundantly supplied with blood vessels, which explains its bright pink or red color, there are no such vessels in the epithelium. Epithelial cells are nourished through the basement membrane.

Despite the fact that the thickness of the epithelium does not exceed 150-200 microns, this coating of internal organs is considered multilayered, i.e. the cells in it are arranged in several layers. Flat epithelium is precisely the closest surface layer of the mucous membrane, consisting of flat-shaped epithelial cells.

There are 3 types of eptheliocytes: superficial, intermediate and basal, located at different levels. The lower layer, closer to the epidermis, is called the basal layer, and a layer of cylindrical (basal) cells that perform a protective function is attached to it.

But our body is constantly in motion and undergoing renewal, which also applies to epithelial cells. In the process of division (proliferation), basal cells form a layer of cells (intermediate cells) that have a complex shape with growths and spines and are located one above the other. Over time, these cells become flat and move into the surface layer, which is renewed regularly once every 5-7 days. Old cells at the very surface of the epithelium are peeled off and, together with mucus and other physiological secretions, come out.

It is this dead squamous epithelium, separated from the main mass, that doctors subsequently find in a smear. It would seem that there is nothing surprising or pathological in this, because this is a natural process of cleansing and renewal of the mucous membrane. In fact, everything depends on the number of detected epithelial cells, and both an increase and a decrease in their number compared to the norm is considered dangerous.

Flat-shaped epithelial cells are found in smears in both men and women, regardless of whether everything is fine with their genitourinary system. Since epithelial renewal is considered a physiologically driven process, it is not surprising that some squamous epithelium will be detected even in a healthy body.

Tests: how to prepare correctly

Sometimes squamous epithelium in a smear may indicate not so much a disease or some non-pathological changes in the body, but rather improper preparation for the test or incorrect taking of a smear. A gynecologist or urologist may prescribe a microflora test if the patient consults him about pain in the pelvic area, redness and swelling of the external genitalia, unusual discharge, as well as symptoms such as burning, itching, pain during urination or sexual intercourse.

Such studies can be prescribed as part of a routine medical examination or when planning pregnancy. In parallel, a urine test is usually prescribed, which helps to identify hidden diseases of the entire urinary system. But they can also manifest themselves in the form of the appearance of epithelial cells and leukocytes in the urine, while a smear allows one to judge only about inflammation at the site of its collection (urethra, vagina or cervical canal).

But no matter what analysis is prescribed, before carrying it out it is necessary to carry out hygienic procedures, i.e. thoroughly rinse the external genitalia with water without using soap or other hygiene products. If they plan to take a smear from the vagina, women think that they need to thoroughly rinse everything inside using douches. In fact, this cannot be done, since the results of the analysis will be distorted (it will not show the real content of leukocytes and epithelial cells separated from the walls).

In order for the smear results to be reliable, it is recommended to abstain from sexual intercourse and the use of contraception two days before the procedure. A visit to the toilet for minor needs should occur no later than 1.5-2 hours before the procedure.

If the cause of inflammation of the cervical tissue is radiant fungi (actinomycetes), a yellowish granular coating is found at the site of the lesion, and Candida fungi leave behind a white mass resembling cottage cheese (grainy and with a sour smell), which is very easily removed from the reddened surface.

A similar plaque is observed in leukoplakia (hyperkeratosis), a disease in which keratinization of the mucous membrane occurs (normally, keratinization of the mucous membrane is not typical). But in this case, unlike a fungal infection, a whitish or grayish coating (it can form on both the cervix and the vaginal mucosa) is difficult to remove, and the smear reveals scales of squamous epithelium, which are the cytoplasm of a cell without a nucleus.

By the way, sometimes doctors find not individual cells in a smear, but layers of squamous epithelium. If these are single formations, there is no need to worry too much, because the cells of the epithelium of the uterus and vagina are arranged in layers, so it is not surprising if they move away from the total mass in a whole area during cell renewal. But if there are a lot of such layers, this may be evidence of dysplastic processes in the uterus (dysplasia, erosion, endometriosis, cervical leukoplakia, precancerous conditions and cervical cancer), so further research and consultation with a gynecologist, and possibly an oncologist, are required.

Acute cervicitis is characterized by the presence of a large number of leukocytes in the smear (leukocytosis), lymphocytes and histiocytes appear, and cylindrical and squamous epithelium are detected. In this case, the cells of the columnar epithelium (basal layer) have an enlarged nucleus, and the flat epithelium of the surface layer in the smear has dystrophic changes (for example, scales appear that do not contain nuclei).

If the disease proceeds in a sluggish form for a long time, large numbers of columnar epithelial cells will be detected in smears, having different sizes and signs of destruction of cellular structures.

• urethritis (inflammatory process in the tissues of the urethra - urethra, which can be diagnosed in patients of both sexes).

Flat epithelium in a smear in men

For men who consult a urologist usually about various discharges from the penis, as well as such unpleasant symptoms as itching, burning and inflammation of the tissues in the urethra, a smear for microflora is taken from the urethra. In addition to bacteria, viruses, fungi and other microorganisms, exfoliated cells of flat and columnar epithelium can also be found in the mucous, whitish or purulent secretion. The urethral mucosa has a slightly different structure, so a small number of basal cells is not a pathology.

If the number of epithelial cells in the smear is higher than normal, we are talking about tissue destruction. So a large amount of flat epithelium, as in the case of women, most often indicates an inflammatory process in the genitourinary system. In this case, it is necessary to take into account not only the urinary organs (kidneys, bladder, urethra).

The inflammatory process can also be localized in the seminal sacs (inflammation of the testicle or orchitis) or the prostate gland (inflammation of the prostate or prostatitis), which are classified as genitals. And since the organs of the urinary and reproductive systems have a common outlet (urethra or urethra), there may be more reasons for discharge from the penis in men than in women, whose outlets, although located nearby, are still separated, which makes diagnosis easier. taking a smear correctly.

If we are talking about an inflammatory process, the smears will also necessarily show an increase in the level of leukocytes (more than 5 units per field of view), which are released by the immune system to fight the infection. Bacteriological studies also reveal the causative agents of the disease, which once again suggests that the appearance of squamous epithelium in the smear is not accidental.

If neither infection nor leukocytes are found in the smears, then we are talking about hyperkeratic processes (leukoplakia, etc.), which can be localized in various areas of the mucous membrane throughout the body. But you need to understand that the amount of squamous epithelium may increase slightly compared to the norm as the human body ages. Although in men this process is not so pronounced, doctors still note some changes in smear tests that are not related to genitourinary diseases.

In both women and men, the increase in the number of epithelial cells in the smear may be temporarily increased due to the use of topical agents. In this case, the situation can be considered as an unusual manifestation of an allergic reaction to the medicine. By analogy, the skin may experience itching, redness and flaking, which is also due to the rejection of surface epithelial cells.

As for the reduced number of epithelial cells in the smear, for young women this is considered an alarming symptom. With the onset of menopause, a decrease in the production of the female hormone estrogen leads to a decrease in such cells in tests, which is considered a physiologically determined age-related process. Disruption of the hormonal balance in the direction of decreased estrogen production in young women before menopause is fraught with big troubles in the form of disruption of the internal environment of the vagina and activation of pathogenic microflora.

With estrogen deficiency, gradual atrophy of vaginal cells occurs, which manifests itself in the absence of natural ovulation discharge, vaginal dryness during sexual intercourse, small vaginal spotting bleeding, burning and itching in the vagina, and frequent urge to urinate. All these are quite dangerous symptoms that can have dire consequences and cause infertility in women of childbearing age. Therefore, it is undesirable to ignore such symptoms.

Consequences and complications

In a smear for microflora, you can detect different types of epithelium: flat superficial, transitional, cylindrical, which lines the cervical canal and is periodically replaced by squamous epithelial cells. There is nothing pathological in the fact that these cells are present in biological material. This is the result of physiological processes occurring in the body. Women may have fewer such cells, women may have more, but this is also due only to the structure of their genital organs. And if the number of cells of a particular type when studying a biomaterial under a microscope does not exceed 15 units in the field of view, there is nothing particularly to worry about.

But if the indicators are too high or below the norm, this is already a reason to specifically take care of your health. Especially when it comes to women of reproductive age.

An increased amount of squamous epithelium in a smear most often indicates inflammatory processes in the urethra or vagina - organs whose surface is covered with a delicate mucous membrane. And as we know, not a single inflammatory process, especially one that lasts for a long time, goes away without a trace. Timely treatment of an acute inflammatory process, which may be indicated by a large number of exfoliated squamous epithelial cells, helps prevent possible complications.

For example, the transition to a chronic form of vaginitis threatens in the future inflammatory processes of the external genital organs, cervical erosion, inflammation of the endometrium, which in turn can eventually lead to dysplastic processes (dysplasia of uterine tissue, endometriosis, cervical cancer). In childhood, vaginitis is fraught with fusion of the labia minora and labia majora in girls.

The inflammatory process can lead to thickening of the mucosal tissue. Metabolic processes are disrupted, cellular respiration is disrupted, and mucosal tissue atrophies. Cracks and erosions may appear on the mucous membrane, which not only become an obstacle to pleasure during sexual intercourse, but also become a breeding ground for the spread of infection. If vaginitis itself is not always caused by an infection, then the appearance of various lesions on the mucous membrane will provoke its attachment.

An infection, especially of a bacterial nature, has the ability to cover increasingly larger areas, i.e. it will move upward, affecting the organs of the urinary system.

Chronic cervicitis can have identical consequences. The infection will gradually spread to other organs, causing inflammation of the appendages, bladder, and peritoneum. Its result may be the appearance of adhesions on internal organs and the development of cancer (cervical cancer does not develop as often against the background of inflammation, but such a danger still exists). In addition, the mere appearance of a large number of cylindrical and flat epithelial cells in a smear may indicate the initial stage of cancer without symptoms of cervicitis.

Urethritis in women, in the vast majority of cases caused by an infectious factor, although damage to the urethra can also be caused by urolithiasis, can cause disruption of the vaginal microflora, inflammation of the bladder and even the kidneys if the infection spreads to them.

In men, untimely or poor-quality treatment of urethritis (and even more so any therapeutic measures) causes many unpleasant consequences that will also affect sexual life:

• development of prostatitis, and as a consequence of prostate adenoma,
• the appearance of vesiculitis, orchitis and colliculitis (inflammatory processes in the seminal vesicles, testicles or seminal tubercle),
• development of balanoposthitis (inflammation of the penis in the foreskin area), etc.

Long-term inflammation in the urethra can lead to the appearance of strictures, i.e. to a narrowing of the urethra, which creates problems with urine removal from the body and often requires surgical intervention.

Patients with inflammatory diseases of the genitourinary system begin to experience problems of a sexual and psychological nature. Pain during sexual intercourse causes refusal of sexual intercourse and constant dissatisfaction of sexual partners. Quarrels and scandals begin in the family, which can also be considered a distant consequence of a careless attitude towards the appearance of a large number of epithelial cells in the smear.

Although no less sexual problems can be observed in women with an insufficient amount of epithelium in smears, in whom the lack of lubrication in the vagina leads to pain and irritation of the mucous membranes during sexual intercourse.

But pathologies in which the composition of the smear changes have much more unpleasant consequences, considering that they sometimes become an obstacle to conceiving a child. And infertility of one of the spouses often leads to family breakdown.

Prevention and prognosis

When it comes to human diseases, the prognosis for their treatment depends on many factors, so it is never one hundred percent. Flat epithelium appears in a smear taken from the genital organs of men and women, depending on its quantity, it can indicate various pathologies caused by hormonal disorders, inflammation, infection, malfunctions of the immune system, etc. It is clear that treatment in each specific case will be considered individually, and its effectiveness will depend on the competence of the doctor.

But the prognosis of treatment is influenced not only by the prescribed treatment. The timing of seeking help also plays a big role. The sooner the disease is detected, the greater the chance of saying goodbye to it without consequences and complications. This applies to both inflammatory pathologies and oncological diseases, where we are no longer talking about health, but about the patient’s life.

It is clear that compliance with the doctor’s requirements will definitely affect the prognosis of treatment. If the patient does not want to undergo the full course of treatment, one usually cannot count on a good, lasting result. There is a high risk that the disease will return after a while.

Let us not once again delve into the details of the consequences that can await a person if he does not take any measures to treat the disease. It’s better to talk about how to make treatment more effective.

When treating infectious and inflammatory diseases of the genitourinary system, it is very important:

• Maintain genital hygiene. You will have to wash even more often than usual, especially during menstruation.
• You will also have to change your underwear and intimate hygiene products (tampons, pads) more often.
• All treatment procedures should be carried out after hands are thoroughly washed with soap. You should also wash your hands after performing medical procedures.
• The genitals, where the infection is hidden, require care using a separate towel. It would be better if they were disposable napkins. Otherwise, the towel will have to be washed and ironed daily with a hot iron.
• Particular attention will have to be paid to underwear. It should be made from natural fabrics, “breathable”, because the “greenhouse” effect created by synthetics only promotes the proliferation of pathogenic microflora.
• During treatment of the disease, sexual contact should be avoided. This will help prevent secondary infection and the spread of infection to other people, in particular to a sexual partner. Failure to comply with this requirement is one of the reasons for the prevalence of sexually transmitted diseases. Some patients believe that once they have started treatment, they are no longer contagious. Unprotected sex is especially dangerous.
• It is important to understand that if two people regularly have sexual intercourse, and one of them is diagnosed with an infectious disease, both partners should be treated. Even if we are not talking about sexually transmitted diseases, for example, candidiasis or vaginitis caused by opportunistic microflora, some preventive measures in the form of treating the penis with antiseptics that are effective against bacteria and fungi will not hurt. Especially when you consider that not everyone can boast of strong immunity.
• Treatment procedures prescribed by a doctor must be performed regularly and in full. Treatment should not be stopped just because the symptoms of the disease disappear. It is necessary to complete a full therapeutic course and then, if necessary, resort to preventive measures.

But any disease is easier to prevent than to cure. It is this truth that you need to be guided in your life so that there are fewer unpleasant moments in it.

To avoid infectious and inflammatory diseases of a urogynecological nature, not much is needed. It is worth paying attention to your sex life. Even if your sexual partner is permanent, you need to carefully monitor your health. After sexual intercourse, hygiene procedures will help prevent possible infection.

If we are talking about casual sex, it is imperative to use high-quality personal protective equipment (condom). And again, do not forget about genital hygiene, trying to take a shower as soon as possible.

Wearing underwear made from natural fabrics will help prevent the proliferation of opportunistic microflora, which loves places where it is warm and humid. Irritation of delicate tissues can be caused by increased humidity, as well as allergens contained in scented pads, synthetic underwear, and some intimate hygiene products, which are best avoided.

As for the prevention of diseases in which the squamous epithelium in the smear differs in quantity from the established norm, here the observance of intimate hygiene, proper nutrition, which provides the body with useful substances necessary for strong immunity, and caution in sexual contacts come to the fore. An important role is also played by maintaining the general health of the body and timely treatment of infectious diseases, regardless of their location. You must always remember the ability of infection to spread throughout the body through the blood and lymph in order to prevent such a danger in time.

When visiting a gynecologist, it is always necessary to take a smear for flora. It can be used to determine the condition of the vaginal mucosa and the presence of infections. Only a doctor who knows the norms of all indicators can decipher a smear correctly. The epithelium in the smear may indicate the presence of an inflammatory process, which may be associated with various reasons.

Indications for the purpose of analysis

There are certain reasons that require a smear test from the vagina or urethra to determine the presence of infections or inflammation in the reproductive system:

• pain localized in the lower abdomen;
• taking antibiotics for a long time;
• the presence of suspicious vaginal discharge that causes discomfort;
• sensation of itching and burning in the genital area;
• pregnancy planning;
• carrying out a preventive examination.

If you have unpleasant symptoms, you should immediately visit a doctor and get a smear and test for the presence of sexually transmitted infections. What epithelium means in a smear depends on the characteristics of its cells and their structure and quantity.

Rules for preparing for analysis

To get a reliable result, you must:

• two days before the smear test, avoid sexual contact;
• do not use vaginal contraceptives (including condoms, ointments, lubricants and creams) and suppositories;
• stop douching two days before the test;
• do not conduct examinations during menstruation, since menstrual blood significantly distorts the test results and may show that the epithelium in the smear is increased; the most correct option would be to take a smear in the first days after the end of menstruation;
• You should not use intimate hygiene products the day before; genital hygiene procedures should be carried out simply with warm water without using any detergents;
• You cannot go to the toilet two hours before taking the test.

Proper preparation for a smear will allow you to most accurately determine the number of cells in it and assess the health of the reproductive system. The epithelium in the smear indicates the condition of the vaginal and cervical mucosa. If the norm changes, one can conclude that there is inflammation or atrophy of the epithelial layer.

Smear technique

A smear for cytology is taken using a special spatula, which is available in a standard gynecological kit intended for examination. It is necessary to take the analysis at the site of transformation (where the squamous epithelium turns into columnar epithelium); after taking the material, it is distributed over a glass slide.

The transformation zone is located in the area of ​​the external pharynx, but in some cases (depending on hormonal balance and age) it can change its position. Taking a smear from the area of ​​transitional epithelium is necessary to accurately determine the presence of malignant cells. Since they appear from the lower layers, taking a smear from the location of the surface epithelium, it will be possible to diagnose cancer only at the last stage.

That is why the epithelium in the smear plays a very important role. The norm in women ranges from 3-15 units in the field of view. If their number is higher, additional examinations need to be carried out to detect a malignant tumor.

What is squamous epithelium and its significance in a smear

The squamous epithelium is the mucous membrane of the vagina. Depending on the phase of the menstrual cycle, cells may undergo minor changes. The surface epithelium is divided into keratinizing and non-keratinizing, the ratio of cells changes in different phases, so it is necessary to take this fact into account in order to determine whether the obtained indicators are normal.

Epithelium in a smear is normal only if its number does not exceed 15 units in the field of view. Exceeding the norm indicates the presence of inflammation or a recent infection. When the structure of cells changes, suspicions arise about the development of a benign or malignant tumor.

The value of columnar epithelium in a smear

The epithelium in the smear, which has a cylindrical shape, is functional, as it ensures the secretion of mucus on the cervix. Normally, the cylindrical epithelium in a smear is represented by groups of cells that have a honeycomb-like or linear structure.

In addition, goblet-shaped cells can be found, their difference is in the cytoplasm stretched with mucus. In some cases, such cells may contain secretion granules. A common pathology, ectopia, is a displacement of the columnar epithelium and its replacement of flat surface epithelium.

Further diagnostic measures

If epithelium is found in the smear, the norm of which is violated, the doctor can diagnose vaginitis. In addition to the high concentration of epithelial cells in the analysis, the woman should have an uncomfortable discharge with an unpleasant odor, itching and pain in the vagina, and redness of the vulva.

Vaginitis is treated with antibiotics, which are combined with antifungal or other drugs, depending on the type of pathogen.

Treatment of non-infectious vaginitis

If the epithelium in the flora smear is increased, and no infections were detected, we can conclude that a non-infectious pathogen is present. These may be hygiene products containing chemicals that cause irritation of the mucous membrane, contraceptives, or with increased sensitivity of the vagina to spermicides.

In these cases, it is enough to stop using the products, and after some time the concentration of epithelium in the smear will itself restore to normal levels. To speed up the effect, you can use suppositories or tablets that normalize the vaginal microflora and allow normal cells to recover faster.

Epithelium in a smear in men

A high content of epithelial cells in the smear can be observed not only in women, but also in men. The most common disease accompanied by an increased amount of epithelium is urethritis. In men, urethritis is accompanied by pain and burning when urinating, a feeling of discomfort and swelling in the genital area and groin, and the appearance of discharge from the penis or blood in the urine and semen.

Female urethritis is accompanied by chills, pain in the lower abdomen, frequent urge to urinate, burning and pain, as well as the presence of atypical vaginal discharge.

Urethritis can be caused by:

• cytomegalovirus;
• herpes simplex virus;
• chlamydia;
• gonococci.

If any virus or bacteria is detected, additional examinations and effective treatment are required.

Atypical epithelial cells in a smear

In some cases, atypical epithelium may be detected in the smear. What does it mean? An altered structure of squamous epithelial cells lining the vagina and cervix may indicate the development of cancerous tumors or dysplasia.

Cervical dysplasia causes cancer in only one percent of women. In other cases, with regular monitoring and treatment, it goes away within a few years. If the disease continues to develop and there is a danger of cancer cells developing, the doctor may recommend a hyperectomy - removal of the uterus and cervix.

Most often, this procedure is performed on women who have reached menopause or women who no longer plan to give birth.

Methods for eliminating atypical cells

If there is a large amount of atypical epithelium, radical methods aimed at destroying cells may be required. After this, the number of cells is normalized, and the epithelium in the smear is restored. The norm for women during the recovery period is individual, so after surgery, after some time you need to visit a gynecologist and take a smear test again.

The following methods are usually used to treat dysplasia:

• Laser therapy is the most modern and effective method. In addition to removing the atypical area, you can also examine its depth and act on all layers of tissue. This procedure is very painful and traumatic, so bleeding may begin after a few days.
• Diathermy - cauterization, is the effect of electricity on an atypical area. It is the fastest and easiest method. After cauterization, scars may remain on the cervix, which in some cases cause the development of infertility.
• Cryothermy is the effect of ultra-low temperatures on the damaged area. The method is effective only in the initial stages of dysplasia. With the development of cancer cells or the occurrence of atypical processes in the cells of the basal layer, it does not produce any results.

All these procedures are aimed at destroying atypical cells under the influence of temperature or a laser beam. In place of the destroyed cells, squamous and cylindrical epithelial cells appear, which are normal for the cervix and vagina.

The epithelium in the smear, the normality of which has been restored after such procedures, will not carry the risk of developing cancer. If the treatment procedures are not effective, it is likely that a hyperectomy (removal of the uterus and cervix) will have to be performed.