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The unsolved mysteries of cytopathology: How to use needles to reveal the hidden secrets of diseases?
In the medical world, there is a science that studies diseases at the cellular level—cytopathology. Founded in 1928 by George Nicholas Papanikolaou, this specialty allows us to peer through the microscope into subtle details and explore the underlying pathologies in our bodies. In this age of ever-advancing technology, cytopathology is not limited to the diagnosis of cancer, but is also involved in many different types of infections and inflammatory diseases.
The core of cytopathology is to evaluate abnormal changes in cells, which are often important indicators that indicate potential lesions.
A common application of cytopathology is the Pap smear, a screening tool used to detect precancerous lesions, specifically for the early detection of cervical cancer. This type of examination is usually performed through sampling and microscopic observation and can help to identify potentially malignant lesions early.
Methods of cell collection
Cell collection methods can be divided into two major categories: exfoliative cytology and interventional cytology. In exfoliative cytology, cells can be collected by natural shedding or mechanical scraping. For example, the Baboba examination is an example of mechanical shedding. In addition, bronchial brushing is performed by inserting a bronchoscope to obtain cell samples from significant lesions in the respiratory tract.
Interventional cytology, on the other hand, involves the active intervention of a pathologist to obtain a sample of cells. An important example is needle aspiration cell (FNAC), which uses fine needles to aspirate diseased areas in various tissues of the body to obtain cell samples.
Needle Aspiration Cytology (FNAC)
Fine needle aspiration cytology is a technique that uses a syringe with a needle to extract cells from lesions or masses in various organs. This procedure usually requires a physician's palpation of the mass or imaging guidance, and its success rate is closely related to the skill of the performer.
In the case of deep lesions, functional imaging (such as ultrasound or CT scan) can assist in guiding the needle, further improving sampling accuracy. When FNAC is performed by a pathologist, the ability to immediately review the sample under a microscope can greatly improve diagnostic accuracy when dealing with the need for small sample volumes.
Sedimentation cytology and printed cytology
In addition to FNAC, sedimentation cytology can also effectively collect cell samples. This process typically extracts the fixative used from biological specimens, which are then centrifuged and allowed to settle to create printed specimens. Printed cytology uses the target tissue to directly contact the glass slide to leave cell imprints. This method also facilitates further staining and analysis of cells.
Cytological preparation and analysis
After sample collection, cell samples need to be processed by direct smear or liquid-based cytology. The advantage of liquid-based cytology is that liquid can be added to the sample for subsequent detection. Commonly used staining methods include Papanicolao staining and Romanovsky staining.
The nucleus of a cell is crucial when evaluating cell samples. The nuclei of cancer cells will show obvious abnormal changes, suggesting the possibility of disease.
The diagnosis of tumors can not only save the patient's life in time, but also reduce the risk of unnecessary surgery. For example, with a thyroid exam via FNAC, doctors can confirm many benign lesions without surgery. If it is diagnosed as malignant, the patient can receive immediate treatment to improve the prognosis.
Final Thoughts
Cytopathology is not only a sharp knife in diagnosing diseases, but also an important tool in medical adventures. It opens a window into the root cause of the disease and provides timely treatment. With the advancement and development of technology, the application prospects of cytopathology are broad. What unsolved mysteries will be revealed by needles in the future?
