Abnormal Pap Smear

Best Abnormal Pap Smear Treatment & Diagnostics in Tardeo, Mumbai

Introduction

Pap Smear, medically known as the Papanicolaou smear, is an examination done using the microscopic method on the cells scraped from the cervix area and around it to detect any cancerous cells or precancerous conditions in the cervix.

The examination is named after the doctor who formulated the entire process in 1928, Dr. George N. Papanicolaou. 

About the topic

Cervical cancer can be sexually transmitted, and certain oncogenic strains of human papillomavirus (HPV) and cervical cancer have a high correlation. It has been shown worldwide that evaluating precursors of cervical cancer via Papanicolaou (Pap) smear significantly diminishes the rate of cervical cancer.

Method of Collection of the Sample

Cervix is made out of columnar epithelium, which covers the exocervix and forms lines with the squamous epithelium and endocervical channel. The point of their intersection is known as a squamocolumnar intersection. Metaplasia propels from the first squamocolumnar intersection inwards and above the columnar villi, building up a space called the change zone.

Screening with regular Pap testing ought to happen each year. This should start when a person is 21 years old or within three years of the beginning of the physical activity and can stop at 70 years old if there is no unusual Pap test that has come through in the previous decade.

A Pap smear test is advised during the second half of the menstrual cycle, i.e., the 14th day. Sample collection for the test begins with giving required essential instructions to the patient about it. Patients who take the test must not have any sexual or physical intercourse and must avoid having contraceptive pills and any kind of vaginal medication from 48 hours before giving the sample for examination. 

The patient undergoing this test is placed in a position known as lithotomy, and the cervix area is visualized using a speculum. The squamocolumnar intersection is scraped by rotating the spatula by 360 degrees. The scraped cells are then spread evenly over a glass slide and need to be treated with ether and 95 percent ethyl alcohol immediately to avoid the artifacts from drying. 

About Abnormal Smear

An abnormal smear has the below-given features:

1. Squamous epithelial cells are present in adequate numbers.
2. The endocervical cells are spread over in an even monolayer.
3. The epithelial cells are not obscured by inflammatory cells, blood, or any other foreign material such as talc or lubricant.

Reporting of PAP Smear 

The reporting classification of Pap smears has evolved and changed through refining over the period. The current way of reporting Pap smear is the Bethesda system. The Bethesda system was introduced in 1988 and was updated later in 1999. 

Patients with signs of abnormal Pap smear but with no detection of any cervical lesion are generally evaluated by biopsy and colposcopy. Colposcopy is done to detect the grade of dysplasia. It can detect the low and high grades of dysplasia but is unable to detect micro-invasive diseases. 

Colposcope gives a three-dimensional picture of the tissue under examination. Screening programs are aimed to detect and eliminate any pre-cancer and cervical cancer.

Request an appointment at Apollo Spectra Hospitals, Tardeo, Mumbai. 

Call 1860 500 2244 to book an appointment.

Limitations of Abnormal PAP Smear

1. There are 8% chances of inadequate sample specimens received.
2. There are 20-30% reports of false or inadequate results, which occur due to the clumping of the cells when they are not evenly spread over the glass.
3. If the cells in the glass are exposed to air for a longer time before it is fixed on the slide, there is a high chance of the cervical cells becoming distorted. 
4. Sometimes other foreign particles in the specimen from the cervical, such as the bacteria, blood, and yeasts, can contaminate the taken sample and can be a limitation to detect any abnormal cells.
5. Human errors might be the number one danger to correct interpretation. 

Conclusion

Every sexually active woman must opt for a Pap examination every year to check for cervical cancer. If the Pap smear is peculiar, it is repeated at 3-6 monthly durations.