ПАП-тест - жидкостная цитология (исследование шейки матки по системе Bethesda 2014г)

Liquid-based cytology of cervical and endocervical samples (Papanicolaou stain) is used to screen for and evaluate precancerous epithelial changes and invasive cervical carcinoma. The assay, widely known as the Pap smear or Papanicolaou smear, concentrates and stains exfoliated cells to identify atypical squamous and glandular cells with high analytic sensitivity. It supports routine population screening and diagnostic assessment when dysplasia, neoplasia, or related cervical pathology is suspected.

Cervical cancer ranks third in incidence among malignant tumors in women, following breast and colorectal cancers, with a global incidence of roughly 15–25 per 100,000 women. Disease is diagnosed most often between ages 35 and 55, is uncommon before age 20, and about one in five cases occurs after age 65. Five‑year survival approaches 88% for localized (in situ) disease but does not exceed 13% for disseminated cancer. Major risk factors include infection with oncogenic human papillomavirus genotypes (notably 16, 18, 31, 33, and 45), cigarette smoking, chlamydial or herpetic infection, chronic inflammatory gynecologic disorders, long-term use of oral contraceptives, family history of cervical cancer, early onset of sexual activity, multiple sexual partners, low dietary intake of vitamins A and C, and states of immunodeficiency including HIV infection. Liquid-based cytology improves sample quality by transferring the cervical and endocervical collection into a preservative medium, removing debris, and creating a uniform cellular layer for Papanicolaou staining. When properly collected—typically with a cytobrush from both the endocervical and ectocervical epithelium and including the transformation zone—this approach enhances detection of atypical cells and precancerous lesions such as cervical intraepithelial neoplasia. In addition to neoplasia, cytology may reveal signs of infection and abnormalities of the endocervix or endometrium. Earlier detection through screening enables timely intervention and reduces adverse outcomes. Screening guidance reflected here recommends beginning screening 3 years after sexual debut and no later than age 21. Starting at age 30, individuals with three consecutive negative results may be screened every 2–3 years. Those with risk factors—such as high‑risk HPV infection or immunodeficiency—should continue annual screening. Women aged 65 years and older with three or more normal results within the prior 10 years may discontinue screening. Continued screening is advisable after a history of cervical cancer, with ongoing papillomavirus infection, or with immune compromise. Individuals who underwent hysterectomy with cervix removal for reasons other than cervical cancer or precancer may stop screening, whereas those with the cervix retained should continue.