PAP test in liquid substrate, vaginal-cervical cytology

HPV infection which As a sexually transmitted disease It is believed to be related to: early onset of sexual life, having multiple partners and disordered sexual behavior, as well as smoking.
Patients with impaired immunity due to HPV infection and the development of invasive cancer are those whose body is unable to intervene in the infection and cell damage caused by the papilloma virus.

At the same time, the genotype of the virus is important in risk factors, as there are more than 100 strains of HPV, and about 40 of them have genital tropism. They are classified according to oncogenicity:

- Low risk: Strains 6, 11, 40, 42, 43, 44, 54, 61, 70, 81 and CP6108, which rarely cause high-grade cervical lesions and cancer progression.

- High risk (oncogenic, hrHPV): Strains 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82, which have been identified in almost all cases of cervical cancer.

The most effective and widely used method, which has been tested in cervical cancer screening programs in many countries and can be performed relatively easily in large populations, is Cervical vaginal cytology or cervical-vaginal cytology, the same Pap test.

Generally, a Pap test is recommended on a regular basis, at intervals of 1-3 years, between the ages of 21 and 65, or 3 years after the start of sexual life, as it is believed that most HPV infections are associated with the first years of sexual life (18-25 years).

A cervical vaginal cytology test (Pap test) performed at Synevo Laboratory uses a modern and new technology different from the traditional Pap smear smear method, the so-called liquid substrate cytology (LBC) method.

Liquid cytology (LBC) method is characterized by:

• Higher accuracy in detecting intrapithelial lesions'
• Minimal cases of misinterpretation of samples;
• Simple and convenient method of taking a smear from the cervix;
• Additional tests may be performed on a single sample, namely HPV (human papillomavirus) detection, genotyping, and screening for sexually transmitted diseases;
• Slides (subject glass) are processed and stained with a special automatic system, which ensures the reception of high quality and standardized study samples;
• The computer analysis system provides a scan of the obtained smear samples and improves the quality of their study and interpretation, which is achieved by the cytologist paying attention to the microscopic fields that are likely to contain anomalies and classify the smear according to a quantitative risk assessment system.

How to prepare for the test?

To perform a Pap test using liquid cytology, the material is taken by a specialist doctor (gynecologist). To take a smear, you need a special brush and a so-called BD vial filled with liquid, which can be taken, if necessary, in "Synevo" laboratory centers. The doctor must also fill out a special referral form where the patient's data and the type of test are marked. The taken material and the application form are sent to "Synevo" laboratory centers, from where it is sent to "Synevo" Central Referral Laboratory.

Transport and fixation vial Cervex brush.

No special training is required for the examination, although it is necessary to follow certain recommendations:

- 24-48 hours before smear is recommended to avoid: sexual intercourse, vaginal shower, intravaginal treatment (creams, contraceptives, disinfectants, lubricants) or other intravaginal interventions (intravaginal tampons, vaginal discharge).

- Pap test is not done during menstruation. It is best to take a smear in the middle of the menstrual cycle. Also, in case of genital infections, after their treatment.

- In case of medical-surgical procedures, smear is recommended before manual examination, colposcopy or 24 hours after it, 3 months after the previous test, and polypectomy, postpartum interval should be 1,5-3 months.

The terms used in the report are:

- Aneoplastic changes - NILM;

- Epithelial cell pathologies: ASC-US, ASC-H, LSIL, HSIL, SCC;

- Glandular cell pathologies - AGC, AIS, adenocarcinoma.