Gynae Cytology

Question 1

What are the statistics of cervical cancer?

Answer 1

600,000 women develop cervical cancer worldwide and half will die.

~2000 develop disease in UK and half will die.

Question 2

Describe the HPV vaccine

Answer 2

From 2019, HPV vaccine is free from NHS for girls and boys (12-13 year olds, but can catch up until 25).

Boys are included as it protect them against some cancers of mouth, throat, anal and genital areas.

NHS uses Gardasil, which protects against strains 6, 11, 16 & 18 of HPV.

Question 3

Describe the NHS cervical screening programme

Answer 3

All women between 25 & 64 should go for regular cervical screening.

Under 25: up to 6 months before turning 25.
25-49: every 3 years.
50-64: every 5 years.
65 or older: only if a recent test was abnormal.

Question 4

Describe liquid based cytology (LBC)

Answer 4

Cervical brush is placed into a vial of preservative (contains fixative - alcohol) ready for LBC.
ThinPrep and SurePath are approved technologies for use.

Question 5

Describe the PAP stain process

Answer 5

1) Ethanol fixation
2) Water
3) Gill’s haematoxylin
4) Water
5) Bluing solution
6) Water
7) 95% ethanol
8) Orange G (keratin)
9) Reagent alcohol
10) Eosine azure (EA50)
11) 95% ethanol
12) 100% ethanol
13) Xylene
14) Mounting
15) Microscopy

Question 6

Describe the process of SurePath

Answer 6

Density gradient centrifugation followed by gravity sedimentation.

Centrifugation: concentrate cells at bottom.

Sedimentation: setting chamber is clamped to a glass slide and cell suspension is added.
Sufficient time allowed for cells to settle on slide under gravity.
Slides may be electrically charged or coated with a suitable material to facilitate cell adhesion.

Question 7

Describe ThinPrep process

Answer 7

Filter chamber is inserted into a vial containing cell suspension.
After vortexing, suspension is drawn through a membrane filter.
Fluid passes through filter while cells adhere to membrane.
Filter chamber is removed from vial and pressed against a glass slide.
Positive pressure helps to transfer cells from filter to slide.
Slides may be electrically charged or coated with a suitable material to facilitate cell adhesion.