ПАП мазок (стекло)\цитологическое исследование мазка из шейки матки с окраской по Папаниколау

Cytologic examination of cervical smears by Papanicolaou stain (Pap test) is used to screen for and aid in the diagnosis of cervical intraepithelial neoplasia and invasive cervical carcinoma. The assay evaluates exfoliated squamous and glandular cells from the ectocervix and endocervical canal to identify cytologic atypia before symptoms arise. Pap smear (cervical cytology) supports population-based screening and diagnostic assessment in women at risk.

Cervical cancer ranks third in frequency among malignant tumors in women worldwide, following breast and colorectal cancers, with an incidence of approximately 15–25 per 100,000 women. Disease onset occurs predominantly between ages 35 and 55, is uncommon before age 20, and about 20% of cases present at 65 years or older. Five‑year survival reaches about 88% for localized (in situ) disease, but falls to 13% or less for disseminated cancer. Major risk factors include persistent infection with oncogenic human papillomavirus types (e.g., HPV16, HPV18, HPV31, HPV33, HPV45 and others), cigarette smoking, chlamydial or herpetic infection, chronic inflammatory gynecologic conditions, long-term use of oral contraceptives, multiparity, family history of cervical cancer, early sexual debut, multiple sexual partners, inadequate dietary intake of vitamins A and C, immunodeficiency states, and HIV infection. Screening recommendations advise testing beginning within three years of sexual debut and no later than age 21. Starting at age 30, individuals with three sequential negative cervical cytology results may extend screening to every 2–3 years. Annual screening should continue for those with risk factors such as high-risk HPV infection or immunodeficiency. Women aged 65 years or older with three or more normal cytology results in the preceding 10 years may discontinue screening, whereas those with a history of cervical cancer, HPV infection, or immunosuppression should continue. Individuals who have undergone total hysterectomy with removal of the cervix for non-neoplastic indications may discontinue testing; those with supracervical hysterectomy should continue screening. Specimen collection targets both the endocervical and ectocervical epithelium, typically using a cytobrush, with immediate fixation on a glass slide in 96% ethanol and staining by the Papanicolaou method. Adequate sampling of the transformation zone is essential because approximately 90% of neoplastic lesions arise at the squamocolumnar junction and only about 10% originate from columnar epithelium. In addition to epithelial atypia, cervical cytology may reveal signs of infection and pathology of the endocervix or endometrium. Early detection through screening enables timely intervention and mitigates adverse outcomes.