What do endocervical cells present mean on a Pap smear. How are squamous metaplastic cells interpreted in Pap test results. Why might a doctor recommend further testing after a Pap smear. What are the common phrases found on standard and irregular Pap test results.

The Significance of Endocervical Cells in Pap Smears

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

Are endocervical cells a cause for concern? In most cases, the presence of these cells is entirely normal and does not indicate any underlying health issues. Their inclusion in the sample helps ensure a comprehensive evaluation of cervical health.

Interpreting Endocervical Cell Findings

• Normal presence: Indicates a thorough sampling of the cervix
• Absence: May suggest the need for a repeat test to ensure adequate sampling
• Abnormalities: In rare cases, may indicate the need for further investigation

It’s important to note that while endocervical cells are typically benign, in some instances, they may show signs of abnormality. In such cases, your healthcare provider might recommend additional testing to rule out any potential concerns.

Understanding Squamous Metaplastic Cells on Pap Smears

Squamous metaplastic cells are another common finding on Pap smear results. These cells represent a normal process of growth and repair within the cervix. When your Pap test report mentions “squamous metaplastic cells present,” it indicates that the pathologist observed cells undergoing this natural transformation.

What triggers the formation of squamous metaplastic cells? Various factors can lead to this cellular change, including hormonal fluctuations, inflammation, or healing processes within the cervix. It’s a normal physiological response and usually not a cause for alarm.

Key Points About Squamous Metaplastic Cells

1. Represent normal cell growth and repair
2. Often associated with hormonal changes or healing processes
3. Generally not indicative of cancer or pre-cancerous conditions
4. May require monitoring in some cases

While the presence of squamous metaplastic cells is typically benign, your healthcare provider may recommend follow-up testing if other abnormalities are noted or if there’s a history of cervical health concerns.

Atypical Squamous Cells: When Further Investigation is Needed

Sometimes, Pap smear results may reveal atypical squamous cells, which require closer attention. The most common classification for these cells is Atypical Squamous Cells of Undetermined Significance (ASC-US).

What does an ASC-US result mean? This finding indicates that the pathologist observed some cellular changes but couldn’t determine their exact nature or significance. While ASC-US doesn’t necessarily imply the presence of cancer, it often warrants further investigation.

Potential Causes of ASC-US Results

• Human Papillomavirus (HPV) infection
• Inflammatory changes in the cervix
• Hormonal fluctuations
• Recent sexual activity or douching

In cases of ASC-US results, your healthcare provider may recommend additional testing, such as HPV testing or a repeat Pap smear after a few months. This approach helps to monitor any changes and ensure appropriate follow-up care.

Squamous Intraepithelial Lesions: Assessing Cancer Risk

Squamous Intraepithelial Lesions (SIL) represent a more significant finding on Pap smear results. These cellular changes are classified as either Low-Grade (LSIL) or High-Grade (HSIL), indicating varying levels of potential cancer risk.

How are SIL findings evaluated? Healthcare providers assess these results carefully, considering factors such as the patient’s age, medical history, and previous Pap smear results. The goal is to determine the most appropriate course of action for further evaluation and potential treatment.

Differences Between LSIL and HSIL

For HSIL results, healthcare providers typically recommend a colposcopy for a more detailed examination of the cervix. This procedure allows for closer inspection of abnormal areas and the collection of tissue samples (biopsies) if necessary.

The Role of Colposcopy in Evaluating Abnormal Pap Results

Colposcopy is a crucial diagnostic tool used to further investigate abnormal Pap smear results. This procedure involves examining the cervix under magnification using a specialized instrument called a colposcope.

Why is colposcopy important in cervical health assessment? It allows healthcare providers to visualize abnormal areas of the cervix that may not be visible to the naked eye. This detailed examination helps in identifying potential precancerous or cancerous lesions that require further attention.

The Colposcopy Procedure

1. Application of a vinegar solution to highlight abnormal areas
2. Examination of the cervix using the colposcope
3. Collection of tissue samples (biopsies) from suspicious areas
4. Evaluation of biopsy results to determine the need for treatment

While a colposcopy may sound intimidating, it’s a relatively quick and minimally invasive procedure. Most patients experience only mild discomfort, and the valuable information it provides far outweighs any temporary unease.

Decoding Common Phrases in Pap Smear Results

Pap smear reports often contain medical terminology that can be confusing for patients. Understanding these phrases can help alleviate anxiety and facilitate better communication with healthcare providers.

Which phrases indicate normal results, and which suggest the need for further testing? Let’s break down some common terms found in Pap smear reports:

Phrases Associated with Normal Results

• Negative for Intraepithelial Lesion or Malignancy (NILM): No signs of precancerous or cancerous changes
• Endocervical Cells Present: Successful sampling of the inner cervix
• Squamous Metaplastic Cells Present: Normal cellular changes observed
• Transformation Zone Component Present: Cells from the cervical canal were collected

Phrases Indicating Potential Abnormalities

• Atypical Squamous Cells of Undetermined Significance (ASC-US): Unclear cellular changes requiring follow-up
• Low-Grade Squamous Intraepithelial Lesion (LSIL): Mild cellular abnormalities
• High-Grade Squamous Intraepithelial Lesion (HSIL): More severe cellular changes
• Atypical Glandular Cells (AGC): Abnormalities in glandular cells, requiring further investigation

Remember, the presence of these phrases doesn’t necessarily indicate a serious condition. They serve as guidelines for healthcare providers to determine appropriate next steps in patient care.

The Importance of Regular Pap Smears in Cervical Health

Regular Pap smears play a vital role in maintaining cervical health and detecting potential issues early. These screenings have significantly reduced cervical cancer rates worldwide by enabling early intervention and treatment.

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

• Ages 21-29: Every 3 years
• Ages 30-65: Every 3 years with Pap test alone, or every 5 years if combined with HPV testing
• Over 65: May discontinue if previous results have been consistently normal

It’s important to note that these are general guidelines, and your healthcare provider may recommend a different screening schedule based on your individual risk factors and health history.

Benefits of Regular Pap Smears

1. Early detection of cervical abnormalities
2. Monitoring of cellular changes over time
3. Opportunity for timely intervention and treatment
4. Reduction in cervical cancer incidence and mortality

By adhering to recommended screening schedules and promptly following up on any abnormal results, you can take an active role in maintaining your cervical health and overall well-being.

Understanding HPV and Its Relationship to Pap Smear Results

Human Papillomavirus (HPV) is closely linked to cervical health and Pap smear results. This common sexually transmitted infection is responsible for the majority of cervical cancer cases worldwide.

How does HPV affect Pap smear results? HPV infections can cause cellular changes in the cervix, which may be detected during a Pap test. Understanding the relationship between HPV and Pap smear findings is crucial for interpreting results and determining appropriate follow-up care.

Key Points About HPV and Cervical Health

• Most HPV infections clear on their own without causing harm
• Persistent high-risk HPV types can lead to cervical cancer
• HPV testing is often performed alongside Pap smears for comprehensive screening
• Vaccination against HPV can significantly reduce the risk of cervical cancer

It’s important to note that a positive HPV test doesn’t necessarily mean you’ll develop cervical cancer. However, it does indicate the need for closer monitoring and potentially more frequent screenings.

HPV and Abnormal Pap Results

Understanding the interplay between HPV and Pap smear results can help you make informed decisions about your cervical health and follow-up care.

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.