What tests can be done to detect early cervical cancer

There are a variety of auxiliary examination methods that can be used to detect cervical cancer early, but the final diagnosis must be confirmed based on the results of pathological sections.

1) Iodine test (Schiller test) This test is to apply iodine solution to the cervix and vaginal wall and observe its staining. There are two commonly used iodine solutions, namely Schiller and Lugol solutions. The former contains 0.33g iodine and 0.67g potassium iodide, and water is added to 120ml. The latter contains 5g iodine and 10g potassium iodide, and water is added to 100ml. Lugol solution is 10 times more concentrated than Schiller solution, and the staining time is short and the effect is good. Lugol solution is now commonly used in clinical practice. The normal cervical vagina and vaginal squamous epithelium are rich in glycogen and are stained brown or dark reddish brown by iodine solution. If there is no staining, it is positive, indicating that the squamous epithelium does not contain glycogen. However, in many cases, the squamous epithelium may not contain or lack glycogen, such as scars, cysts, cervicitis or cervical cancer. The squamous epithelium does not contain or lack glycogen and does not stain. Immature metaplastic epithelium is often not stained. Griffiths and Younge reported that 8.3% of cervical carcinoma in situ did not stain. Therefore, this test is not specific for cancer and can only detect epithelium without glycogen. However, the iodine test is used to detect CIN and cervical cancer mainly to identify the risk area of ​​cervical lesions in order to determine the site for biopsy and improve the diagnosis rate.

2) Cervical smear cytology Since Papanicolaou and Traut reported the effective method of diagnosing cervical neoplasms by cervical smear cytology, cervical smear cytology has become a major method for screening cervical epithelial abnormalities, called Pap smear. Vaginal fluid is smeared on a glass slide to make a smear, which is then stained and observed under a microscope for changes in the exfoliated cells in the vaginal fluid and the presence of cancer cells. This method is a simple and accurate method for screening cervical cancer during large-scale surveys.

3) TBS diagnostic system Since the Pap smear was used in 1940, the methods of obtaining, preparing and evaluating specimens have changed little. Although it is very effective in screening for cervical precancerous lesions, the false negative rate of a single test is about 20%. Half of the false negatives are due to improper specimen sampling, and the other half are due to failure to distinguish or accurately interpret abnormal cells.