Cervical Cancer - Investigations
The ectocervix is covered by squamous epithelium
The endocervical canal by mucus secreting columnar epithelium
The Squamocolumnar junction
before puberty pH is alkaline
after puberty it is acidic, due to bacterial breakdown of glycogen
at puberty hormones cause extension of the columnar epithelium onto the ectocervix
exposure of columnar epithelium to acid environment induces squamous metaplasia and the transformation zone
site of most of the epithelial diseases that occur in the cervix
Screening in the form of a Papanicolaou (Pap) smear provides the key to early detection and improved survival chances.
The components of the PAP stain are:
Harris’s haematoxylin as a nuclear stain
Orange G (stains keratin when present)
Eosin: stains pink cytoplasm, nucleoli and cilia
Light green; stains blue cytoplasm of metabolically active cells
Bismarck Brown; doesn’t add any distinctive colour
collected in a similar way to the Pap smear
brushing cells from the neck of the womb
a thin layer of the cells is deposited onto a slide
examined under a microscope by a cytologist
disturbed chromatin distribution
abnormal staining ◦ e.g. hyperchromatic or hypochromatic or polychromatic
Less important than nuclear changes, include variation in: total cell size ad shape
abnormal cytoplasmic staining
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