About 2,800 patients in Poland get cervical cancer every year, of which 1,600 die. These numbers can be reduced through preventive examinations. FemiMea has the latest, most sensitive equipment that is currently available in the world.
Incorrect cytology and what is next?
– the traditional next step after an abnormal smear test – relies on the presence of visible indicators to detect atypical cells on the cervix. Unfortunately, these indicators are not specific to cervical intra-epithelial neoplasia (CIN), especially low-grade CIN, which means that interpretation is subjective. That’s why we take biopsies to confirm the presence of disease before offering treatment. But biopsies are invasive – and as it can be difficult to judge the best location, we sometimes need to take more than one tissue sample, which can add to patient discomfort. Even after the biopsy is complete, it can take up to two weeks to receive the histology results, making waiting patients understandably anxious. In the majority of cases, the abnormal tissue will regress naturally, so to avoid unnecessary and potentially harmful treatment, we tend to recall these patients for repeat colposcopy at six- to 12-month intervals – only increasing the time and effort, in addition to uncertainty for the patient.
examines cervical epithelial resistance.
ZedScan allows us to assess the structure of the cervical epithelium based on its electrical impedance spectrum. Normal epithelial tissue has a very regular and structured architecture with tightly packed cells, so it exhibits a high impedance (resistance) to the flow of an electric current. The more abnormal the tissue becomes, the more this architecture starts to break down. That makes it easier for an electric current to pass through the tissue, so the impedance drops. The ZedScan device applies a small current across the cervix and measures the impedance at 14 different frequencies to generate a spectrum.
During a colposcopy procedure, we take 10–12 readings from around the transformation zone, which takes about three minutes in total. Each measurement is compared to a standard, allowing the device to characterize the tissue and identify areas of high-grade dysplasia. Once the examination is complete, results are immediately displayed on the handset. Areas of high-grade disease appear as a red or amber dot on the screen, indicating where the measurement was taken so that we know straight away whether to offer treatment, take a biopsy or discharge the patient.
Electrical impedance spectra improve our team’s ability to identify and treat women with high-grade precancerous CIN – important because the risk of development into cancer is significantly higher than with low-grade dysplasia. ZedScan also yields an objective, reliable and reproducible result – and because we get it in real-time, we have greater ability to employ the “see and treat” method, where women with severe abnormalities can be treated immediately without requiring biopsy. That also eliminates the need to bring patients back later for treatment, minimizing the cost to them in terms of time, effort and anxiety. And negative results are just as useful; we spend a large proportion of clinic time on follow-up appointments to monitor women with low-grade abnormalities. A negative ZedScan result reassures us that no severe abnormalities are present, letting us safely discharge those women to routine screening and free up appointments for new patients.
- BLUE STAINING with FRD solution
We are the only one clinic in Poland that uses the Folate Receptor-mediated Detection staining solution which enables a rapid in vitro chemical staining of cervical exfoliated cells to detect folate receptor overexpression. In the clinical practice, FRD can be used as a primary screening tool for precancerous and cancerous lesions, in triage for women with ASCUS cytology, and as a co-test for women with an HPV-positive test result.
1. Folic acid-reduced methylene blue (MB) conjugate binds to the folate receptors expressed on the cervical epithelium membrane and then endocytosis occurs.
2. The acidic micro-environment in the endosome causes dissociation between the folic acid and reduced MB from the folate receptors.
3. Reduced MB is released into the cytoplasm, where the oxidation-reduction reaction occurs, and reduced MB becomes oxidized.
4. The folate receptors recycle back to the cell membrane.
5. Oxidized MB exits from the cell and can be detected, providing visual result.