What do endocervical and squamous metaplastic cells on a Pap smear mean. How to interpret different Pap smear results. When should you be concerned about your Pap smear results. What are the next steps after an abnormal Pap smear.

Understanding Endocervical Cells in Pap Smear Results

Endocervical cells play a crucial role in Pap smear interpretations. These mucus-producing glandular cells, located within the inner cervix (endocervix), are often sampled during a Pap smear procedure. When your results indicate “endocervical cells present,” it simply means that the healthcare professional successfully collected cells from your endocervix during the test.

Are endocervical cells in a Pap smear result concerning? Generally, the presence of endocervical cells is not a cause for alarm. It’s a standard finding that indicates the test adequately sampled the cervical area. However, in rare cases, if cancer cells are detected in the endocervix, your Pap smear may indicate some form of carcinoma, such as adenocarcinoma or squamous cell carcinoma.

Key Points About Endocervical Cells:

• Mucus-producing glandular cells from the inner cervix
• Their presence in Pap results is usually normal
• Indicates successful sampling of the cervical area
• Rarely associated with carcinoma if abnormal cells are detected

Squamous Metaplastic Cells: What They Mean on Your Pap Smear

Squamous metaplastic cells are another common finding in Pap smear results. These cells represent the normal growth and repair process of cervical tissue. The term “squamous metaplastic cells present” on your Pap smear results indicates that the pathologist observed cells undergoing this natural transformation.

Should you be worried about squamous metaplastic cells? In most cases, the presence of these cells is not a cause for concern. It’s a sign that your cervical tissue is renewing itself, which is a normal physiological process. However, in some instances, changes in these cells may warrant further investigation.

Understanding Squamous Cells:

• Found in various tissues, including the outer surface of the cervix (ectocervix)
• Thin, flat-shaped cells
• Can undergo metaplasia (transformation) as part of normal tissue repair
• Most cervical cancers originate from squamous cells

Atypical Squamous Cells of Undetermined Significance (ASC-US)

One of the more common abnormal Pap smear results is Atypical Squamous Cells of Undetermined Significance (ASC-US). This finding indicates that the pathologist observed irregular cells but couldn’t determine the exact cause of the irregularity.

What causes ASC-US results? There are several potential reasons for ASC-US findings:

1. Human Papillomavirus (HPV) infection
2. Inflammatory changes in the cervix
3. Noncancerous changes that may resolve on their own

Is ASC-US a sign of cancer? While ASC-US results can be concerning, they don’t necessarily indicate cancer. In many cases, these changes are due to benign causes and may resolve without intervention. However, your healthcare provider may recommend further testing, such as HPV testing or repeat Pap smears, to monitor the situation.

Squamous Intraepithelial Lesions (SIL): Low-Grade vs. High-Grade

Squamous Intraepithelial Lesions (SIL) represent another category of abnormal Pap smear results. These findings indicate the presence of precancerous changes in the cervical cells. SIL is further classified into two categories: Low-Grade (LSIL) and High-Grade (HSIL).

Low-Grade Squamous Intraepithelial Lesions (LSIL)

LSIL indicates mild changes in the cervical cells. These changes are often associated with HPV infections and have a lower risk of progressing to cancer. In many cases, LSIL may resolve on its own without treatment.

High-Grade Squamous Intraepithelial Lesions (HSIL)

HSIL represents more severe changes in the cervical cells and carries a higher risk of developing into cervical cancer if left untreated. When HSIL is detected, your healthcare provider will likely recommend further examination through a colposcopy.

How is a colposcopy performed? During a colposcopy, your doctor uses a special microscope called a colposcope to examine your cervix under magnification. This procedure allows for a more detailed view of the cervical tissue and enables the doctor to take targeted biopsies of any suspicious areas.

Decoding Standard Pap Smear Result Phrases

Understanding the terminology used in Pap smear results can help alleviate anxiety and facilitate better communication with your healthcare provider. Here are some common phrases associated with standard Pap smear results:

• “Endocervical cells present”: Indicates successful sampling of the inner cervix
• “Endocervical cells absent”: No endocervical cells were collected during the Pap smear
• “Endometrial cells present”: Cells from the uterine lining were collected
• “Squamous metaplastic cells present”: Normal changes in cervical cells were observed
• “Negative for intraepithelial lesions or malignancy (NILM)”: No signs of precancerous or cancerous changes
• “Acute inflammation”: Presence of white blood cells in the sample
• “Transformation zone component present/absent”: Indicates whether cells were collected from the cervical canal
• “Atrophic changes”: Possible signs of menopause in the cervix

Understanding Phrases That May Require Further Testing

While many Pap smear results are normal, some findings may necessitate additional testing or follow-up. Here are some phrases that might indicate the need for further evaluation:

• “Atypical squamous cells of uncertain significance (ASC-US)”: Irregular cells of unknown cause
• “Atypical glandular cells (AGC)”: Abnormalities in glandular cells
• “Low-grade squamous intraepithelial lesion (LSIL)”: Mild precancerous changes
• “High-grade squamous intraepithelial lesion (HSIL)”: More severe precancerous changes
• “Squamous cell carcinoma”: Indicates the presence of cervical cancer cells
• “Adenocarcinoma”: Suggests cancer originating in glandular cells

What should you do if your results indicate the need for further testing? If your Pap smear results fall into any of these categories, it’s crucial to follow up with your healthcare provider promptly. They will guide you through the next steps, which may include additional testing, more frequent Pap smears, or referral to a specialist.

The Importance of Regular Pap Smears and Follow-Up Care

Regular Pap smears play a vital role in the early detection and prevention of cervical cancer. By identifying abnormal cell changes before they progress to cancer, Pap smears have significantly reduced cervical cancer rates worldwide.

How often should you get a Pap smear? The frequency of Pap smears depends on various factors, including your age, medical history, and previous Pap smear results. Generally, guidelines recommend:

• Women aged 21-29: Pap smear every 3 years
• Women aged 30-65: Pap smear and HPV test every 5 years, or Pap smear alone every 3 years
• Women over 65: May stop screening if they have a history of normal results

These guidelines may vary based on individual risk factors and medical history. It’s essential to discuss the appropriate screening schedule with your healthcare provider.

The Role of HPV Testing in Cervical Cancer Screening

Human Papillomavirus (HPV) testing has become an integral part of cervical cancer screening. HPV is responsible for the majority of cervical cancer cases, and identifying high-risk HPV types can help guide further management and follow-up.

How does HPV testing complement Pap smears? HPV testing can be done alongside or instead of a Pap smear, depending on your age and risk factors. When combined with Pap smears, HPV testing can provide a more comprehensive assessment of your cervical health and help determine the appropriate follow-up intervals.

Coping with Abnormal Pap Smear Results

Receiving abnormal Pap smear results can be anxiety-inducing, but it’s important to remember that most abnormal results do not indicate cancer. Here are some strategies to help cope with the situation:

1. Educate yourself: Understanding your results can help alleviate fears and empower you to make informed decisions about your health.
2. Communicate with your healthcare provider: Don’t hesitate to ask questions and seek clarification about your results and recommended next steps.
3. Follow up as recommended: Adhere to your healthcare provider’s recommendations for further testing or follow-up appointments.
4. Seek support: Talk to trusted friends, family members, or a counselor if you’re feeling anxious or overwhelmed.
5. Maintain a healthy lifestyle: Focus on overall health through proper nutrition, regular exercise, and stress management.

Remember, abnormal results often resolve on their own or with minimal intervention. Your healthcare provider will guide you through the process and ensure you receive appropriate care and follow-up.

In conclusion, understanding the various components of Pap smear results, including endocervical and squamous metaplastic cells, can help you navigate your cervical health with confidence. Regular screenings, open communication with your healthcare provider, and adherence to recommended follow-up care are key to maintaining optimal cervical health and preventing cervical cancer. By staying informed and proactive, you can play an active role in safeguarding your reproductive health for years to come.

Endocervical and Squamous Metaplastic Cells on a Pap Smear

Seeing squamous metaplastic or endocervical cells on your Pap smear test results may raise some questions and concerns. However, the presence of these cells isn’t usually a cause for concern.

The phrase “endocervical cells present” simply means that your doctor sampled cells from the inside of your cervix during the Pap smear. The phrase “squamous metaplastic cells present” means that the pathologist who examined your Pap smear found cells that were growing and repairing themselves regularly.

In this article, we take a look at squamous and endocervical cells and what they mean on a Pap smear test result. We also decode the meaning of other terms that may show up on a Pap test. Read on.

Squamous cells are types of cells found in various tissues throughout your body, including:

• your skin
• the outer surface of the cervix (ectocervix)
• the linings of your organs

When changes occur within these thin, flat-shaped cells, they may be described as metaplastic.

Most cancers of the cervix and vagina are squamous cell carcinomas. However, the presence of squamous metaplastic cells in your Pap test results doesn’t automatically mean cancer. It just means that these cells were sampled during the Pap smear and that the pathologist who examined them found them to be growing in a standard manner.

Atypical squamous cells of undetermined significance (ASC-US)

If the pathologist finds atypical squamous cells of undetermined significance (ASC-US), this usually means that the pathologist has found irregular cells and could not determine why they were irregular.

This could mean that you have an HPV infection, in which case your doctor will need to conduct further testing for HPV to confirm. The irregular cells could also be due to other inflammatory or noncancerous changes of the cervix that will likely resolve on their own.

Squamous intraepithelial lesions (SIL)

Squamous cells that may be precancerous or more likely to turn into cancer are described on a Pap test result as squamous intraepithelial lesions (SIL). These may be further classified as low-grade (LSIL) or high-grade (HSIL), indicating a low to high risk of cancer development.

In the case of HSIL, your doctor may recommend further examination of these cells using a colposcopy.

A colposcopy allows a doctor to examine your cervix under magnification using a colposcope, which is a microscope with a bright light. They can also take tissue samples of irregular cells that can be sent to a lab for further examination by a pathologist.

Endocervical cells are mucus-producing glandular cells located within the inner cervix (endocervix). During a Pap smear, your doctor or nurse may take a sample of these cells, but not always.

If your Pap smear results doshow that endocervical cells are present, it means that your test included cells from your endocervix as part of the sample examined under a microscope. It’s standard to have endocervical cells, and their presence does not indicate cancer or precancer.

However, if cancer cells are detected in the endocervix, your Pap smear may indicate some form of carcinoma. Adenocarcinoma or squamous cell carcinoma are the two most common cell types for cancers of the cervix.

Your doctor will most likely recommend a colposcopy to examine these areas in more detail and gather tissue samples.

While your Pap smear results may indicate a standard result, it can be concerning to see codes and phrases and not know their meaning. If your doctor recommends further testing, it’s helpful to understand what your Pap test results show so that you can have an informed discussion with your doctor.

Below is a breakdown to help you decode common phrases you may see on both a standard and irregular Pap test result:

Phrases associated with standard results

Phrases that may mean you need further testing

If your Pap smear results are standard, you do not need to take any further action. Unless told otherwise by your doctor, you may stick to your regular Pap testing schedule.

On the other hand, if any irregularities are found, your doctor will likely order further testing. According to the American Cancer Society, next steps could include:

• a physical exam
• blood testing
• a follow-up Pap test in 1 year
• HPV testing
• colposcopy to examine the cervix, especially if your HPV test is positive
• cervical biopsies, which consist of tissue samples taken directly from the cervix for further lab testing

How often should you have a Pap smear?

The general guidelines for Pap smears are as follows:

• Ages 21 to 29. Every 3 years.
• Ages 30 to 64. Every 3 years or a combination of Pap and HPV testing every 5 years.
• Age 65 and older. Your doctor may recommend that you stop having regular Pap smears if you have never had an irregular result and have had at least two negative tests in a row.

If you’ve recently had an irregular Pap smear or are considered to be at high risk for cervical cancer, your doctor may recommend more frequent testing.

You should also still see your OB-GYN annually. Pap smear guidelines change often, and your doctor can let you know if and when you need a Pap smear or other gynecological testing.

Was this helpful?

When it comes to reporting Pap smear test results, most medical professionals will either tell you that your results were standard or that you may need to undergo further testing to confirm possible irregularities.

It’s important to discuss any concerns about your Pap smear results with your doctor. Also follow any next steps, including further testing recommendations.

Cervical cancer screenings are designed to detect possible precancer and cancerous cells for the earliest possible treatment.

Endocervical Cells and Pap Test

Every time I go for my yearly Pap smear exam, my cytology report comes back saying “no endocervical cells present. ” My ob-gyn says this is not unusual after menopause. I keep thinking if they are not looking at cervical cells, then what good is the Pap test for me? I could have cervical cancer and it would not be detected. What is your thought on this dilemma, and what can I do about it?

A Pap smear involves lightly scraping the surface of the cervix to collect cells. A pathologist then examines a Pap smear under a microscope, looking for two types of cervical cells: squamous cells, which are typically found in the outer surface of the cervix, and columnar endocervical cells, which come from the lining of the narrow opening in the cervix leading to the inside of the uterus (the endocervical canal).

Pathologists report on the appearance of both types of cells, and they report if no endocervical cells are seen, as in your case. Your ob-gyn is correct that this is not unusual in a woman who has gone through menopause. The reason is that after menopause, the cervix may be less pliable and the transformation zone (the section of the endocervical canal where squamous cells begin to change to columnar cells) moves higher up the cervical canal, making it more difficult to routinely obtain endocervical cells. However, in a premenopausal woman, the transformation zone is fairly close to the opening of the cervix, allowing the smear to capture both types of cells easily.

It will probably be reassuring to you to know that all the Pap smears that you have had did indeed look at the surface cells of the cervix, so the test has still been useful. Women whose Pap smears show no endocervical component but who have had otherwise normal results and are not seeing abnormal bleeding or other symptoms generally do not need another Pap smear performed until the next annual examination.

At your next yearly exam, you could discuss with your ob-gyn your concern about prior Pap smears lacking an endocervical component. He or she may be able to make a special effort to reach the endocervical canal with the Pap instrument. Sometimes, if it is difficult to reach the cervical canal, a small brush can be inserted into the canal to obtain the endocervical component.

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Cytological examination with Leishman’s stain (with a description of the cytogram), 2 slides, Papanicolaou’s stain hand over in Moscow

PAP test, or cytological examination of smears from exo- and endocervix by the Papanicolaou method, is a screening method for diagnosing cervical pathology. This type of cytological examination is recommended by most communities and is included in modern clinical guidelines. For the purposes of this analysis, PAP test is carried out by the classical method, namely the material is applied to the glass. Smears are taken by a doctor using special endobrushes (cytobrushes) for isolated smears from the surface of the cervix (exocervix) and from the cervical canal. Smears are applied to glass, which will later be sent to cytologists to evaluate the material obtained. The Papanicolaou method is the most accurate examination of exo- and endocervix cells. Unlike other methods, several complex stains are used to better stain the cytoplasm and nuclei. The smear is also fixed with 96% alcohol. This technique reduces the number of errors made due to insufficient preparation of the material directly for the study, and also allows cytologists to evaluate the most stained material. The description of the cytogram is always detailed, and the conclusion is according to the existing classification of Bethesda.

Smear quality assessment:
The material is complete, contains cells of flat and cylindrical epithelium in sufficient quantity.

Unsatisfactory for assessment (uninformative) material, Poor number of cells or their absence.

Cytogram within normal limits (NILM):
Contains cells of the superficial and intermediate layers of stratified squamous epithelium, metaplastic epithelium cells, leukocytes, cylindrical epithelium cells, endometrial epithelial cells.

Metaplasia (normal), squamous metaplastic epithelium cells indicate that the material was taken from the transformation zone.

Reactive changes:
Cytogram of inflammation, degenerative and reactive cell changes, inflammatory atypia, squamous metaplasia, hyperkeratosis, parakeratosis, koilocytosis and other signs of viral damage.

Atrophy, cells of basal and parabasal types – small cells with a hyperchromic nucleus and poor cytoplasm. They can often be misinterpreted as cells with atypia, giving a false positive cytology result.

Pathological changes in the epithelium:
ASCUS (atypical squmous cells of undetermined significance) Changes that are difficult to differentiate between reactive epithelial changes and dysplasia. In ASCUS, cells are detected that are difficult to interpret – cells with dyskaryosis, enlarged and hyperchromic nuclei. Dynamic observation and additional examination is recommended, namely, repeated cytological examination after 6 months and HPV testing. In case of confirmation of ASCUS and the presence of human papillomavirus of high oncogenic risk, a colposcopy is performed. Studies show that 20% of women with ASC have dysplasia after a more thorough examination.

Precancerous changes:
LSIL (CIN I), a mild intraepithelial lesion involving human papillomavirus infection. Surveillance without active therapy is recommended. In most women, LSIL regresses on its own within a few years. All changes with low malignant potential are grouped into this group, since the cytologist often cannot distinguish between changes in HPV infection and CIN 1.

HSIL (CIN II-III), moderate to severe intraepithelial lesion. It is recommended to remove all affected tissues by the method (conization) with subsequent morphological examination. This group includes all changes with a high malignant potential.

AGC (atypical glandular cells), Atypical cells of the columnar epithelium. Curettage of the cervical canal for histological examination is recommended.

Tumor changes:
Squamous cell carcinoma, a malignant tumor of the squamous epithelium.

Glandular cancer, a malignant tumor of the glandular epithelium of the endocervical type.

Endometrial cancer, a malignant tumor that develops from the lining of the uterus and grows into the cervical canal.

Pap test. What do the abbreviations say?

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Pap test. What do the abbreviations say?

Every woman who has ever been to a gynecologist knows that at the reception they will definitely take smears from her, including for a cytological examination. In many cases, only after a comprehensive examination of the cervix – extended colposcopy, smears for flora and cytology, and, if necessary, a biopsy – the specialist will be able to establish a diagnosis and prescribe the optimal method of treatment.

The term “dysplasia” or “neoplasia” will no longer surprise women, even those who are far from medicine. They understand that we are talking about the presence of atypical cells, which can be in both malignant and benign processes.

And yet, when you hold the result of a smear with incomprehensible abbreviations in your hands, there is always excitement.

What is cytological screening and why every woman should undergo it?

— Inna Vitalievna, tell us what is the PAP test and how often should it be taken?

— Pap test, also called cytological screening, helps to detect and treat moderate and severe precancerous conditions of the cervix in a timely manner. Regular screening at the onset of sexual activity significantly reduces the risk of developing cervical cancer. In most countries of the world, it is recommended to take a Pap test every three years from the age of 21, but Ukrainian doctors consider it expedient to start it in Ukraine earlier, from the age of 18, and complete it at 65, as in most countries of the world. This is due to certain epidemiological features: early onset of sexual activity, the prevalence of various forms of immunodeficiency, an extremely low level of HPV vaccination and a large number of cases of smoking among women.

— Do I need to prepare for a Pap test?

— It is better to be examined in the first dry days after menstruation. For women who take birth control pills, it does not matter which day of the cycle to take the test, and women in menopause can take it on any convenient day. 48 hours before the test, you should exclude sexual intercourse, do not use vaginal suppositories, irrigation, gels and creams.

The Pap test is a painless procedure. Some women may experience discomfort and aching pain in the lower abdomen during the sampling. This is fine.

Cellular material is taken with a special brush, which is placed in a container with a fixing transport solution or applied in a thin layer on a glass slide. Cotesting (simultaneous cytological examination and determination of the human papillomavirus (HPV) by the polymerase chain reaction method) makes the first, but confident steps in Ukraine.

– What might be the results of this study? What is recommended for each of them?

– For a descriptive cytological conclusion, the Bethesda classification is used, according to which the results are interpreted:

• ASCUS – inflammation or mild dysplasia of unclear significance;
• LSIL – low-grade squamous intraepithelial lesion (traditional cytology CIN I (Cervical Intraepithelial Neoplasia) or “mild dysplasia”;
• HSIL – high-grade squamous intraepithelial lesion (traditional cytology CIN III/CIN III) or “moderate-severe dysplasia”;
• NILM – absence of intracellular lesions or malignancy, that is, the “norm”.

Often, women and especially young girls come with an incomprehensible result of a cytological examination of the cervix and with an exciting question “What to do next?” Upon receipt of any of the results of the PAP test, there are absolutely clear and scientifically based methods of additional examination and patient management tactics, which are based on international recommendations and evidence-based medicine data.

If you receive a “Poor Bethesda Cytology” result, it is recommended that you repeat the Pap test in 2-4 months (regardless of age).

Conclusion ASCUS (Atipical Squamous Cells of Undetermined Significance, atypical squamous cells of unknown significance) – characterizes such structural changes in cells, which are qualitatively and quantitatively insufficient for the diagnosis of CIN. This means that the cytological picture does not allow differentiating changes in the squamous epithelium between reactive and dysplastic, that is, precancerous. In most patients with these results, the cellular composition normalizes during follow-up, but 10-20% progress to dysplasia. However, the risk of developing severe CIN III dysplasia in women with ASCUS and a negative result for HPV (-) does not exceed 1-2%, therefore, such patients are observed without the use of invasive examination methods, and the tactics of observation depend on age and the presence or absence of highly oncogenic types of HPV in study of urogenital secretions.

Screening result ASC-H (Atypical Squamous Cells Can not Exlude HSIL) – regardless of HPV status, extended colposcopy is recommended, and biopsy, cervical curettage is indicated for any signs of damage. In women of peri- and menopausal age, if the transition zone of the squamous and columnar epithelium of the cervix is ​​NOT visualized colposcopically, and curettage did not provide reliable information, conization of the cervix can be considered as a diagnostic measure. Such an intervention should be performed by an expert-level specialist. Further tactics depend on the results of histological examination.

Pap test with result CIN I or LSIL (Low-grade Intraepithelial Lesion, mild epithelial lesion) – Cytological changes due to HPV (koilocytosis) and non-specific inflammatory changes. CIN I often regresses on its own, therefore, in this group of patients, dynamic monitoring tactics are most often used. However, it is imperative to perform an HPV test to determine further tactics.

For women with CIN I and HPV (-), cytological control after 6 months is recommended, a double cotesting test after 12 months is possible. If after 12-18 months. based on the results of observation, we obtain NILM – it is recommended to move on to routine screening.

For women with CIN I / HPV (+), colposcopy is recommended, and if severe damage to the cervical epithelium is detected, a biopsy, and in its absence, repeated cytological control after 6 months. or double test after 12 months. In such patients, it is necessary to create conditions for the elimination of HPV: it is recommended to stop smoking, if necessary, to treat chronic infections, correct the vaginal microbiome – candidiasis, bacterial vaginosis, chronic herpes infection, etc. It is worth remembering that 12-25% of HPV ( +) Women with CIN I may progress to more severe CIN within 4 years.

In the presence of a cytological conclusion of CIN II and CIN III or HSIL, in 70-80% of cases, patients have CIN II / III in the histological material after biopsy and cervical curettage, and in 1-3% – invasive cancer. Therefore, regardless of HPV status, colposcopy is always recommended by a trained specialist, biopsy of altered areas under colposcopy control, endocervical curettage in non-pregnant women, followed by a morphological study of the material obtained. A colposcopic examination of the vagina is also recommended. In cases with a cytological result of CIN II/III, if colposcopy shows no changes or a mild lesion is detected, biopsy and endocervical curettage (if not performed before) and/or diagnostic cone biopsy are recommended.

As an exception, girls under 21 years of age. The risk of invasive cancer is extremely low, and colposcopy and cytology should be repeated after 3-6 months, provided that the colposcopy is adequate, that is, the transformation zone is visualized, and endocervical curettage is negative.

Human immunodeficiency virus (HIV) testing is always recommended prior to invasive procedures, as these women are at increased risk for cervical neoplasia.

— What to do if there is a histological confirmation of mild or moderate and severe cervical dysplasia?

— If a low-grade LSIL lesion (mild dysplasia, CIN I) is detected on biopsy and if the colposcopy results are satisfactory (the type 1 transformation zone is completely visible), two approaches are possible: observation, which is recommended in most cases, or active treatment, which may be considered for signs of long-term persistence of CIN I.

Surveillance is the best management strategy, especially for young women and those planning pregnancy. It consists in cytological control + HPV testing + colposcopy every 6 months until there is cytological and colposcopic evidence of regression of mild dysplasia. It is worth noting that in patients with untreated CIN I, there is a 13% risk of detecting CIN II, CIN III during two years of follow-up.

Surgical, namely excisional treatment of CIN I may be offered to patients with long-term persistence of the lesion for more than 18 months, especially those with a positive HPV status and in women older than 30 years; patients who do not have reproductive plans and refuse to undergo regular control gynecological examination; women with a positive HIV status.

With histological confirmation of HSIL, that is, CIN II and CIN III, the treatment tactics are more likely to be surgical. However, it is worth remembering that about 40% of cases of CIN II can regress within 2 years, especially in young women. CIN III regression is extremely rare.

Treatment recommendations for severe CIN III dysplasia are unanimous: mandatory removal of the pathologically altered part of the cervix, i. e. excision / conization in non-pregnant patients. The only exception is HSIL (CIN II) in girls under 21 years of age, in the absence of a positive HIV status, since young patients are more likely to regress. In this category of patients, it is also desirable to conduct an immunohistochemical study of the proliferative activity index using monoclonal antibodies to the p16 or p16 / Ki67 protein to clarify the biological potential of dysplastic changes in the cervical epithelium. Observation is possible in the absence of p16 overexpression for no more than 12 months. With persistence of HSIL (CIN II) and HPV (+) for more than 12 months. The use of excisional treatments is recommended. Surgical treatment of HSIL (CIN II / III) can be performed by trained experts under colposcopy guidance.

Since the cervix is ​​covered not only with a flat, but also with a cylindrical glandular epithelium, which is located in the cervical canal, accordingly, oncological problems also occur here.

The cytological conclusion of the PAP test – AGC (cervical intraepithelial lesion of glandular cells) and AIS (adenocarcinoma in situ) in each case requires a consultation with a cytologist, oncogynecologist, gynecologist of an expert level.

Atypical glandular cells in a cytological smear may be of endocervical origin, i.e. from the cervix, or endometrial, i.e. from the uterine cavity. Therefore, all patients in this group are recommended extended colposcopy and cervical curettage. Examination over the age of 35 includes mandatory endometrial curettage or hysteroscopy, especially in the presence of concomitant extragenital pathology (obesity + diabetes mellitus + hypertension), pathological uterine bleeding and a family history burdened with cancer.

If there is atypia of glandular cells or AIS on biopsy but no evidence of invasive cancer, conization of the cervix may be considered as the method of choice in young patients with reproductive plans for the future, however, women who have realized their reproductive function and do not plan to give birth in the future are recommended hysterectomy – removal of the uterus, especially with histologically confirmed AIS, taking into account the high probability of incomplete removal of the lesion during conization (up to 26%) or invasive cancer (1. 2%), frequent relapses of the disease after treatment, the multifocal nature of the disease, and the uninformative cytological manifestations of AIS.

Remember that with early detection of cervical cancer, the disease has a favorable prognosis for treatment and full recovery, so you should take care of your own health first of all!

You can undergo an examination by a gynecologist, pass all the necessary tests, do a Pap test and, if necessary, undergo treatment for identified precancerous diseases at the Israeli Oncology Hospital LISOD. The best oncogynecologists will give a detailed consultation on the results of the tests and prescribe an effective treatment.

Sign up for a consultation:

0-800-500-110 — free of charge within Ukraine;

+ 38-044-277-8-277.

the 14 th of July
Cervical cancer is not psychomatic.