A Pap test, Pap test or cytological smear ( English Papanicolaou test , Pap test or Pap smear ) is a test with which you can determine precancerous or cancerous cells in the vagina and cervix (see Malignant neoplasms of the cervix ). Named after the Greek scientist Georgios Papanicolaou .
- 1 General information
- 2 Preparation for the study
- 3 Interpretation of results
- 3.1 Cytological classification according to Papanicolaou
- 4 References
Pap test allows you to quite effectively detect precancerous changes in the epithelium - cervical intraepithelial neoplasia of varying severity.
This type of study is mandatory for women older than 30 years, especially those who have previously detected or are currently found to have the human papilloma virus of high oncogenic risk, as well as for women who have found areas of altered epithelium during colposcopic examination of the cervix.
The number of drugs (glasses) can be from 1 to 3. Most often, it is necessary to study two drugs - the epithelium from endocervix and exocervix. The material must be taken using special cytobrushes. Methodology for preparing the drug for cytology according to Papanicolaou.
The biomaterial is taken using a special cervical brush. Immediately after taking the biomaterial, a smear-imprint is prepared, touching the surfaces of the glass slide with all surfaces of the cytobrush. The probe is disposed of. The prepared smear is dried in air. A glass with a dried smear is placed in a cuvette and fixed with rectified 96% ethyl alcohol for 5 minutes.
The finished product should be placed in an individual package (plastic or paper bag), attached to the direction with a stapler and sent to the laboratory. It is allowed to store glasses with fixed or dried strokes in sealed packaging at a temperature of 2-8 ° C for 10 days.
According to international standards, the first Pap test is performed 3 years after the onset of sexual activity or at the age of 21 years (depending on what happens sooner). Then - once a year. If for 3 consecutive years the results of the Pap test do not detect changes in the structure of the cells of the cervix, the Pap test is carried out once every 2-3 years to 65 years. After 65 years, the Pap test can be stopped, provided that all previous results were negative.
To obtain the most accurate result, it is necessary to fulfill a number of conditions before conducting the Papanicolaou test. It is not recommended to conduct an examination during menstruation, in the presence of any inflammatory process. Recommend that patients 48 hours before taking a PAP smear refrain from sexual contact, use of tampons , the use of any vaginal creams, suppositories and drugs, douching and vaginal douche. It is also advisable to take a shower instead of a bath 2 days before the Pap test. A smear should be taken before a gynecological examination, colposcopy or not earlier than 48 hours after these manipulations.
Interpretation of results
Pap smear can be positive or negative (Pap class I). Normally, there are no atypical cells, all cells are of the same shape and size (negative Pap smear). The presence of cells of different shapes and sizes, their pathological position is characterized as a positive Pap smear.
Pap smear classification
- 1st grade - normal cytological picture;
- 2nd class - a change in cell morphology due to the inflammatory process in the vagina and (or) the cervix;
- 3rd class - single cells with an anomaly of nuclei and cytoplasm (suspected malignant neoplasm);
- 4th grade - individual cells with clear signs of malignancy;
- Grade 5 is a large number of typically cancer cells. The diagnosis of malignant neoplasm is not in doubt.
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