Department of Clinical Laboratory Diagnostics, Russian Medical Academy of Continuous Professional Education.
Department of Obstetrix and Gynecology, Russian Medical Academy of Continuous Professional Education.
Klin Lab Diagn. 2021 Mar 13;66(2):87-94. doi: 10.51620/0869-2084-2021-66-2-87-94.
A cytological examination of uterine cavity material has proven to be the effective method of detecting and clarifying the diagnosis of cancer and non-tumor endometrial diseases. However, sometimes there are difficulties in interpreting the results in a traditional (classical) cytological examination, due to high level of inadequate samples: the presence of mucus, a large number of blood elements, structures of poorly visible cells in the wrong preparation of the smear. At present, the method of liquid cytology, based on the technology of preparation of standard thin-layer cytological preparations from liquid cell suspension, is increasingly developed and widespread. These slides, if necessary, can be used for morphometry, cytochemical, immunocytochemical studies etc. It is also possible to prepare cell blocks from this material, and to obtain information about the histological structure if small pieces of tissue are presented in cytological material, moreover, to use these blocks for immunohistochemical reactions. Material from the uterine cavity may contain tumor cells from ovarian, tubal or other non- endometrial carcinoma, and it is necessary to obtain information about their origin, to verify the morphological diagnosis and to determine the management and treatment of patients, as a lot of problems concerning ovarian and endometrial cancer remains unclear. Examination of aspirates and scrapes from the uterine cavity using advanced molecular techniques, together with existing examination methods, can help to form risk groups for uterine, tubal, ovarian and even peritoneal tumors. The review of literature contains comparative characteristics of different methods and their combinations, which allow improving diagnostics of non-tumor lesions and endometrial tumors.
宫腔细胞学检查已被证明是检测和明确癌症和非肿瘤性子宫内膜疾病诊断的有效方法。然而,在传统(经典)细胞学检查中,由于样本不足、黏液存在、大量血液成分、涂片制备不当导致细胞结构难以辨认等原因,有时会出现结果解读困难的情况。目前,基于从液体细胞悬浮液制备标准薄层细胞学制剂技术的液基细胞学方法得到了越来越多的发展和广泛应用。如果需要,这些载玻片可用于形态计量学、细胞化学、免疫细胞化学等研究。也可以从该材料制备细胞块,如果细胞学材料中存在小块组织,则可以获得关于组织学结构的信息,此外,还可以使用这些块进行免疫组织化学反应。宫腔内的材料可能含有来自卵巢、输卵管或其他非子宫内膜癌的肿瘤细胞,因此需要获取其来源的信息,验证形态学诊断,并确定患者的管理和治疗方案,因为许多与卵巢和子宫内膜癌相关的问题仍然不清楚。使用先进的分子技术对宫腔抽吸物和刮取物进行检查,并结合现有的检查方法,可以帮助形成子宫、输卵管、卵巢甚至腹膜肿瘤的风险群体。文献综述包含了不同方法及其组合的比较特征,这有助于改善非肿瘤性病变和子宫内膜肿瘤的诊断。