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During recent years, indications have extended beyond cases that involved the ectocervix to include lesions with margins not defined at colposcopy.
Studies of immortalized normal human vaginal, endocervical, and ectocervical cultures and primary murine vaginal, endocervical, and ectocervical tissues suggest differential TGase 1 expression; TGase 1 is expressed in the vagina and endocervix but not in the ectocervix.
Cervical sampling should be conducted by means of gentle scraping of the ectocervix with a curved spatula, followed by insertion and rotation of an endocervical brush.
Specimen adequacy: The cervix must be properly visualized, and both the endocervix and ectocervix should be thoroughly sampled .
Furthermore, because cervical cancer and its precursor states have a tendency to begin in the transition zone which lies between the ectocervix and endocervix, collecting cells from the transition zone is critical to the early detection of this highly preventable and treatable disease.