EN
jp 
ko 
fr 
de 
pt 
ar 
es 
ru 
fa 
id 
Cervical cancer is one of the most common malignancies in women. It is a gynecological malignancy that occurs in the cervix, typically associated with Human Papillomavirus (HPV) infection. The high-incidence age group is typically 36 to 55 years old.
According to the 2023 ICO/IARC Human Papillomavirus and Related Diseases Report for China, both the incidence and mortality rates of cervical cancer rank third among female malignancies in China, posing a serious threat to women's health.
In recent years, cervical cancer has shown a trend towards affecting younger women. Furthermore, due to the deep anatomical location of the cervix, patients often cannot detect it through self-examination. This leads to many cervical cancer patients being asymptomatic even in the middle or late stages of the disease, resulting in the spread of cancerous tissue.
Cervical Liquid-Based Cytology (LBC) is a screening method that involves two main steps:
1. Cell Sample Collection
It primarily involves collecting exfoliated cells from the cervical surface and the endocervical canal.
These cells naturally shed due to the metabolism of cervical tissue.
During the examination, the physician uses a specialized cervical brush to gently rotate a few times at the cervical os and within the endocervical canal to collect a sufficient quantity of cell samples.
2. Specimen Preparation and Examination
The collected cell samples are preserved in a special liquid medium. This medium prevents cell distortion and destruction and allows the cells to be uniformly dispersed.
The sample is then processed using high-precision automated equipment, which includes filtration and centrifugation to remove impurities (such as blood, mucus, etc.).
A thin-layer slide is prepared, and the pathologist observes the morphology and structure of the cells under a microscope.
Cervical Liquid-Based Cytology is one of the most widely used screening techniques in China. Its advantages include accuracy, speed, simplicity, and cost-effectiveness, and it is a non-invasive examination.
Women who are sexually active have an increased risk of infection with pathogens such as Human Papillomavirus (HPV), which can lead to cervical lesions. Sexual activity may cause damage to the cervical epithelial cells, making it easier for pathogens to invade. Long-term chronic inflammatory stimulation can also lead to abnormal changes in cervical cells. Therefore, women with a history of sexual activity should undergo regular LBC screening for early detection of cervical lesions.
Having multiple sexual partners increases the risk of HPV infection. HPV is one of the main risk factors for cervical cancer and pre-cancerous lesions. Studies show that the greater the number of sexual partners, the higher the likelihood of HPV infection. Women with multiple sexual partners should pay close attention to cervical health and undergo regular LBC screening to promptly detect potential lesions.
The risk of developing cervical lesions increases with age. On one hand, the body's immunity gradually declines, weakening the resistance to pathogens. On the other hand, long-term chronic inflammatory stimulation and cell aging may lead to abnormal changes in cervical cells. Some studies have found that women over 50 years old have a higher risk of cervical cancer and pre-cancerous lesions. Therefore, older women should undergo regular LBC screening for early detection and treatment of cervical lesions.
Irregular Vaginal Bleeding: Such as non-menstrual bleeding or post-coital (contact) bleeding, which may be a signal of a cervical lesion. LBC is required to rule out the possibility of cervical cancer or pre-cancerous lesions.
Abnormal Vaginal Discharge: When there is increased discharge, foul odor, abnormal color, or blood-streaked discharge, it may be related to cervical lesions, and LBC should be performed promptly.
HPV infection is the main cause of cervical cancer, especially the persistent infection with high-risk HPV types, which significantly increases the incidence of cervical cancer. Therefore, these women need LBC screening for early detection of cervical changes.
Long-term use of oral contraceptives can alter hormone levels in the body, which may increase the risk of cervical lesions.
Immunodeficiency disorders lead to a decrease in the body's immune function, making it easier to contract pathogens like HPV, thereby inducing cervical lesions.
These women require LBC cervical screening for the early detection of cervical cancer and pre-cancerous lesions.
If there is a family history of cervical cancer, the risk of the disease is increased for relatives. Regular LBC screening is recommended to detect potential cervical lesions early.
The development of cervical cancer is a progressive process, typically evolving from Cervical Intraepithelial Neoplasia (CIN) to invasive cancer. CIN is classified into Grade Ⅰ, Ⅱ, and Ⅲ. While the majority of CIN Ⅰ lesions can spontaneously regress, CIN Ⅱ and Ⅲ have a high potential for malignant transformation.
TCT screening can detect abnormalities at the early stage when cellular morphological changes occur. At this point, the lesion is still superficial, and timely treatment can effectively prevent the lesion from progressing to cervical cancer. For example, clinical studies have shown that patients with CIN Ⅱ-Ⅲ identified through TCT screening have a higher cure rate after appropriate treatment, such as cervical conization.
Compared to the traditional Papanicolaou (Pap) smear, TCT screening offers significant improvements in specimen collection and processing. Traditional Pap smears may miss some abnormal cells due to factors like thick smears or cell overlap.
TCT uses a specialized sampling brush and preservation fluid, which collects more cervical cells and ensures they are uniformly dispersed on the slide. This allows the pathologist to observe cell morphology more clearly, significantly reducing the occurrence of false-negative results and thus increasing the detection rate of cervical cancer and pre-cancerous lesions.
In addition to screening for pre-cancerous lesions and cancer, TCT can also detect some benign cervical conditions, such as inflammation and microbial infections. The detection report may provide clues regarding the presence of inflammatory cells, Trichomonas, Candida, or other infection-related findings. For instance, when a report suggests a large number of inflammatory cells, it helps the physician diagnose potential cervicitis, allowing for timely anti-inflammatory treatment.
1. It is best to undergo the examination 3–7 days after the end of menstruation. During this period, cervical secretions are relatively scarce, which is conducive to collecting high-quality cell samples and can reduce the risk of bleeding during the procedure.
2. Avoid sexual intercourse for 2–3 days before the examination. Sexual activity may introduce pathogens (bacteria, viruses, etc.) and could cause cellular morphological changes due to irritation, potentially leading to false-positive or false-negative results.
3. Do not perform vaginal douching for at least 48 hours prior to the examination. Douching can disrupt the balance of the normal vaginal flora and may wash away pathological cells, affecting the accuracy of the test. Similarly, do not use vaginal suppositories or other medications before the examination, as they may cover the cervical surface, preventing the collected cell sample from accurately reflecting the cervical condition.
4. The patient should inform the physician of her past medical history, such as a history of cervical lesions, HPV (Human Papillomavirus) infection, or gynecological inflammation. She should also disclose any history of allergies, especially to reagents that may be used during the examination (e.g., lubricants on the cervical brush). If she has had a surgical history, such as a total hysterectomy, this must also be communicated to the physician, as it will affect the method and focus of the examination.
Cervical LBC Liquid-Based Cytology serves as a preliminary screening method and cannot replace pathological histological diagnosis. If atypical or suspicious malignant cells are found, further relevant examinations should be performed to confirm the diagnosis and determine the appropriate treatment. Furthermore, women should undergo regular gynecological examinations and screening to timely detect and manage cervical lesions and malignancies.
