What is a cervical biopsy?

宫颈活检是一种从宫颈取出组织以检查异常或癌前病变的过程, or cervical cancer.

The cervix is the lower, narrow part of the uterus. It forms a canal that opens into the vagina.

Cervical biopsies can be done in several ways. The biopsy can remove a sample of tissue for testing. It can also be used to completely take out abnormal tissue. It can also treat cells that may turn into cancer.

Types of cervical biopsies include:

• Punch biopsy. 这个程序使用一个圆形刀片，像一个纸孔打孔器，去除组织样本. One or more punch biopsies may be done on different areas of the cervix.

• Cone biopsy. 该手术使用激光或手术刀从子宫颈切除一大块锥形组织.

• Endocervical curettage (ECC). 该手术使用一种称为刮管的狭窄工具刮取宫颈内管的衬里. This is an area that can’t be seen from the outside of the cervix.

Why might I need a cervical biopsy?

当盆腔检查发现异常时，可进行宫颈活检. It may also be done if abnormal cells are found during a Pap test. A positive test for human papillomavirus (HPV) may also call for cervical biopsy. HPV is a type of sexually transmitted infection. 某些类型的HPV会导致宫颈癌和其他不太常见的生殖器癌症. A cervical biopsy is often done as part of a colposcopy. This is also called a colposcopy-guided cervical biopsy. 阴道镜检查使用一种带有特殊透镜的仪器来观察宫颈组织.

A cervical biopsy may be done to find cancer or precancer cells on the cervix. 看似异常但尚未癌变的细胞被称为癌前细胞. 这些不正常的细胞可能是多年后可能发展成癌症的第一个征兆.

宫颈活检也可用于诊断和帮助治疗以下疾病:

• Noncancerous growth (polyps) on the cervix

• Genital warts. These may mean that you have an infection with HPV. HPV is a risk factor for cervical cancer.

• Diethylstilbestrol (DES) exposure if your mother took DES during pregnancy. DES raises the risk for cancer of the reproductive system.

Your healthcare provider may have other reasons to recommend a cervical biopsy.

What are the risks for a cervical biopsy?

Some possible complications may include:

• Infection

• Bleeding

此外，锥体活检可能会增加不孕和流产的风险. 这是因为手术可能会在子宫颈产生变化和疤痕.

Tell your healthcare provider if:

• You are allergic to or sensitive to medicines, iodine, or latex.

• You are pregnant or think you could be pregnant. 有些类型的宫颈活检可以在怀孕期间进行，但有些则不能.

如果可能，宫颈活检将安排在月经后一周左右.

You may have risks depending on your specific health condition. 在手术之前，一定要和你的医生谈谈你的任何担忧.

Certain things can make a cervical biopsy less accurate. These include:

• Menstruation

• Acute pelvic inflammatory disease

• Acute inflammation of the cervix

How do I get ready for a cervical biopsy?

• Your healthcare provider will explain the procedure and you can ask questions.

• 你将被要求签署一份同意书，允许你做这个手术. Read the form carefully and ask questions if something is not clear.

• 在简单的宫颈活检之前，你通常不需要停止进食或饮水. If your biopsy needs anesthesia, you may need to fast for a certain number of hours before the procedure. This is usually after midnight.

• Tell your provider if you are pregnant or think you may be pregnant.

• Tell your provider if you are sensitive to or are allergic to any medicines, latex, tape, or anesthetic medicines (local and general).

• Tell your provider about all medicines you are taking. 这包括处方、非处方药和草药补充剂.

• Tell your provider if you have had a bleeding disorder. 如果你正在服用任何血液稀释药物(抗凝剂)，也要告诉你的医生。, aspirin, or other medicines that affect blood clotting. You may need to stop taking these medicines before the test.

• 在手术前24小时内，你不应该使用卫生棉条、阴道乳霜或药物，也不应该使用冲洗液.

• You should not have sex for 24 hours before the procedure.

• 你的医疗保健提供者可能会告诉你在手术前30分钟服用止痛药. 或者在麻醉开始前给你一些药物来帮助你放松. You will need someone to drive you home afterward.

• You may want to bring a sanitary pad to wear home after the procedure.

• Follow any other instructions your provider gives you to get ready.

What happens during a cervical biopsy?

You may have a cervical biopsy in a healthcare provider’s office, as an outpatient, or during a hospital stay. Some biopsy procedures only need local anesthesia. Other need regional or general anesthesia. 测试的方式可能会根据您的病情和您的医疗保健提供者的做法而有所不同.

Generally, a cervical biopsy follows this process:

1. 你需要完全脱光衣服，或者只穿腰部以下的衣服，穿上病号服.

2. You will be told to empty your bladder before the procedure.

3. 你将躺在检查台上，支撑着你的脚和腿，就像骨盆检查一样.

4. 你的医疗保健提供者会把一种叫做窥器的仪器放入你的阴道. This will spread the walls of the vagina apart to reach the cervix.

5. Often the healthcare provider will use a colposcope. 这是一种带有特殊透镜的仪器，就像显微镜一样，可以帮助观察宫颈组织. The provider will put colposcope at the opening of your vagina. It will not enter your vagina.

6. 医生会通过阴道镜检查宫颈或阴道的问题部位.

7. 他或她可以用醋溶液(醋酸溶液)清洁和浸泡子宫颈。. 这种溶液有助于使异常组织变白，使它们更容易被看到. You may feel a mild burning sensation. An iodine solution may be used to coat the cervix. This is called the Schiller test.

8. 活检的类型取决于异常细胞的大小和形状, as well as where they are.

9. 医疗保健提供者可能会用小针麻醉该区域注射药物.

10. He or she may use forceps (tenaculum) to hold the cervix steady for the biopsy. You may feel some cramping when the tenaculum is put in place.

11. 切除组织的数量和位置取决于活检的类型. For a simple cervical biopsy, 将使用一种特殊类型的镊子取出一个或多个小的组织样本. When this is done, you may feel a slight pinch or cramp. 宫颈管内部的细胞可以用一种叫做宫颈刮匙或宫颈刷的特殊工具去除. This may also cause some cramping.

12. For a cone biopsy, 提供者可以使用环形电手术切除程序(LEEP)或冷刀锥活检程序. 对于冷刀锥活检，激光或外科手术刀可以用来去除组织. This procedure needs regional or general anesthesia.

13. 活检部位出血可用膏状外用药物治疗. 医生也可以使用探针(电灼)或缝线(缝合)来止血.

14. After a cone biopsy, the provider may pack the cervix with a pressure dressing. Your provider will tell you how to remove this packing.

15. The provider will send the tissue to a lab for testing.

What happens after a cervical biopsy?

你的恢复情况取决于活检的类型以及你是否进行了麻醉.

如果你进行了局部或全身麻醉，你将被带到恢复室接受观察. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. 如果你在门诊做了这个手术，你应该安排有人开车送你回家.

在简单的活检后，您可以在手术后休息几分钟再回家.

You may want to wear a sanitary pad for bleeding. It is normal to have some mild cramping, spotting, and dark or black-colored discharge for several days. 深色分泌物是涂在子宫颈上的止血药造成的.

Take a pain reliever for cramping as recommended by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.

You may be told not to douche, use tampons, or have sex for 1 week after a biopsy, or for a period advised by your healthcare provider.

在宫颈活检后，在你的宫颈愈合之前，你不应该把任何东西放进阴道. This may take several weeks. You may also have other limits on your activity, including no heavy lifting.

你可以回到你的正常饮食，除非你的医疗保健提供者不这样做.

您的医疗保健提供者将告诉您何时返回进行进一步治疗或护理. 一般来说，做过宫颈活组织检查的妇女需要更频繁的巴氏试验.

Tell your healthcare provider if you have any of the following:

• Bleeding

• Foul-smelling drainage from your vagina

• Fever and/or chills

• Severe lower abdominal pain

Your healthcare provider may give you other instructions after the procedure, depending on your situation.