Bapes-Papanicolau

What Is a Pap Test?

A Pap test is a screening test of a sample of cells taken from a woman's cervix . The test is used to look
for changes in the cells of the cervix or vagina that show cancer or conditions that may develop into
cancer. It is the best tool to detect precancerous conditions and hidden, small tumors that may lead to
cervical cancer. If detected early, cervical cancer can be cured.
Make sure you get a Pap test to check for cervical cancer every one-two years if you are 21 or older. If
you are sexually active and have a higher risk for STDs, get tests for chlamydia, gonorrhea, and syphilis
yearly. Take an HIV test at least once, more frequently if youre at risk.

How Is a Pap Test Performed?

The Pap test is done during a pelvic exam. We use this device called a speculum to widen the opening
of the vagina so that the cervix and vagina can be examined. We introduce it longitudinally, then we
rotate transversally and we go futher with our specullum. We open it, to see the cervix and we lock it so
we can have a constant view of it.
We take a small brush like this to collect cells from the endocervix and ectocervix. After the cells are
taken, they are placed eighter into a solution, eighter we smear it on the glass slide.then the sample is sent
to a lab for testing.

What increases your risk for an abnormal Pap test?

Certain sexual behaviors, like having sex without condoms and having more than one sex partner (or
having a sex partner who has other partners), can increase your risk for getting HPV. And HPV raises
your risk for having an abnormal pap test.

HPV can stay in your body for many years without your knowing it. So even if you now have just one
partner and practice safer sex, you could still have an abnormal Pap test if you were exposed to HPV in
the past.

Smoking or having an impaired immune system also raises your chances of having cell changes in your
cervix.

Do abnormal cell changes cause symptoms?

The cell changes themselves don't cause symptoms. HPV, which causes most abnormal Pap tests, usually
doesn't cause symptoms either.
If a different sexually transmitted infection is the cause of your abnormal test, you may have symptoms
such as:
A discharge from the vagina that isn't normal for you, such as a change in the amount, color,
odor, or texture.
Pain, burning, or itching in your pelvic or genital area when you urinate or have sex.
Sores, lumps, blisters, rashes, or warts on or around your genitals.

What will you need to do if you have an abnormal Pap test?

You may need more tests to find out if you have an infection or to find out how severe the cell changes
are. For example, you may need:

Colposcopy, a test to look at the vagina and cervix through a lighted magnifying tool.
An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix.
Human Papillomavirus (HPV) Test

A human papillomavirus (HPV) test is done to check for a high-risk HPV infection in women. HPV is
a sexually transmitted infection (STI). An HPV test checks for the genetic material (DNA) of the human
papillomavirus. Like a Pap test, an HPV test is done on a sample of cells collected from the cervix .
This test will show whether a high-risk type of HPV is present. In women, high-risk types of HPV (such
as types 16, 18, 31, and 45) cause changes in the cells of the cervix that can be seen as abnormal changes
on a Pap test. Abnormal cervical cell changes may resolve on their own without treatment. But some
untreated cervical cell changes can progress to serious abnormalities and may lead to cervical cancer over
time if they are not treated.
The cervical canal is lined with a single layer of column-shaped cells, while the ectocervix is covered
with multiple layers of cells topped with flat cells. The two types of epithelia meet the squamocolumnar
junction. Infection with the human papillomavirus (HPV) can cause changes in the epithelium, which can
lead to cancer of the cervix. Cervical cytology tests can often detect cervical cancer and its precursors,
and enable early successful treatment. Ways to avoid HPV include avoiding sex, using condoms, and
HPV vaccination. HPV vaccines, developed in the early 21st century, reduce the risk of cervical cancer
by preventing infections from the main cancer-causing strains of HPV.

Another Pap test in about 6 to 12 months.

A colposcopy is usually done before any treatment is given. During a colposcopy, the doctor also takes a
small sample of tissue from the cervix so that it can be looked at under a microscope. This is called a
biopsy.
Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate, or severe. In
moderate to severe cases, you may have treatment to destroy or remove the abnormal cells.
What Do the Results of a Smear Pap Test Mean?
A normal Pap test means the cells from the cervix look normal.
An abnormal Pap test means the cells do not look normal. This might mean an infection ( the cells arent
very abnormal)_ such as
Micoze de tip candidozic
Trichomonas vaginalis
Cocobacili
Gardenerella vaginalis
Actinomyces
Virusul Herpes simplex
Chlamydia
Abnormal Pap Test might also mean pre-cancerous changes.
First we must know that The endocervical mucosa is lined with a single layer of columnar mucous
cells, and contains numerous tubular mucous glands which empty viscous alkaline mucus into the lumen.
In contrast, the ectocervix is covered with nonkeratinized stratified squamous epithelium,[3] which
resembles the squamous epithelium lining the vaginal. The junction between these two types of epithelia
is called the squamocolumnar junction.. On the slide we normally see both tipe of cells.

Atypical Squamous Cells (ASC) of the Cervix

Atypical squamous cells (ASC) are abnormal cells found on a Pap test, but the reason for the
abnormalities is not known. The causes of ASC include infection and inflammation.
ASC is further classified as:
ASC of undetermined significance (ASC-US). ASCUS is a term used for Pap test results that the doctor
is unsure about. Some cells appear different from a normal cervix under a microscope, but do not fit into a
well-defined category. could be an early warning of a pre-cancer change (dysplasia) or cervical cancer,
and should always be followed up
L- SIL ( Low-grade Squamous intraepithelial lesion) = changes of the squamos epithelium from the
first third of it. (Depth /height). the size, shape and other characteristics of the cells suggest that if a
precancerous lesion is present, it's likely to be years away from becoming a cancer.
H-SIL ( High-grade Squamous intraepithelial lesion) means changes of the squamos epithelium from
the superior two thirds of it. . there's a greater chance that the lesion may develop into cancer much
sooner. Additional diagnostic testing is necessary. (COLPOSCOPY + biopsy)
AGC ( Atypical glandular cells.) Glandular cells produce mucus and grow in the opening of your cervix
and within your uterus. Atypical glandular cells may appear to be slightly abnormal, but it's unclear
whether they're cancerous.
Further testing is needed to determine the source of the abnormal cells and their significance.

Squamous cell cancer or adenocarcinoma cells. This result means the cells collected for the Pap
smear appear so abnormal that the pathologist is almost certain a cancer is present.

"Squamous cell cancer" refers to cancers arising in the flat surface cells of the vagina or cervix.
"Adenocarcinoma" refers to cancers arising in glandular cells. If such cells are found, your doctor will
recommend prompt evaluation.
Sometimes repeat Pap tests are needed. Different tests also may need to be done, such as
a colposcopy (the use of a special microscope to examine the cervix and vagina).

Why Would I Need to Repeat the Pap Test?

A repeat Pap test may be necessary if there were not enough cells collected during the test. Since
decreased levels of the female hormone estrogen also can influence Pap test results, menopausal women
may need to take estrogen before they repeat the test. This is not an abnormal result but is called
unsatisfactory for evaluation.