Information
Cytological analysis of tissue samples taken from the cervix during a gynecological examination is an auxiliary method in the diagnosis of cervical cancer. It shows us the degree of suspicion of precancerous conditions. A cervical smear can be performed using a classic Pap smear with a stick on a glass slide, or a more modern method called LBC smear, in which the sample cells are collected in a liquid medium. At our clinic, we prefer and perform cytology using the LBC method, which allows for more accurate diagnosis.
Advantages of LBC sampling and analysis
After sampling using the LBC (liquid-based cytology) technique, the preparations from the liquid medium are produced in the laboratory, where mucus and red blood cells are removed and the cells are evenly spread on a glass slide in a thin layer, making the smear easier to diagnose under a microscope. If a client needs additional genetic testing for HPV, this can be done from the stored sample container, and the client does not have to go back to the gynecologist for another examination. In addition, the LBC technique also allows for additional immunocytochemical analyses, i.e., analyses using a contrast medium, which can detect the presence of the p16 oncogene, a protein that indicates cancerous changes in cells.
A sample obtained by a classic Pap smear of the cervix contains approximately 160,000 to 200,000 cells, and it is possible that during evaluation in the laboratory, the human eye under a microscope may overlook the presence of a few cancer cells among healthy ones. Therefore, diagnosis based on microscopic analysis of a Pap smear is only 60 to 70% effective. In contrast, diagnosis using a computer that scans the entire slide prepared using the LBC technique with cervical cells allows all suspicious or cancerous cells to be identified with almost 100% certainty.
How to read cytology results
Findings from cytological analysis that warrant further attention are marked by the laboratory with written abbreviations. Below you can read what the individual findings mean. Cytology is an auxiliary method and the recommendations below are general. Therefore, they need to be approached individually.
ASC-US
An ASC-US finding means that the smear result is slightly abnormal and the risk of serious precancerous changes is very low. However, a check-up is necessary. Most often, a follow-up cytology smear is performed in three to six months. If the next cytology is still abnormal, it is advisable to consider a more detailed examination of the cervix (colposcopy, biopsy, HPV testing, etc.). It is not possible to determine from the smear whether this slight deviation was caused by HPV (human papillomavirus)
LSIL
This finding means that the result is slightly abnormal, but the risk of serious precancerous changes is very low. If this finding is repeated in the next follow-up smear, it is necessary to verify the finding by performing a biopsy. Most often, a follow-up cytology smear is performed after six months. If the cytology is still abnormal, it is advisable to consider a more detailed examination of the cervix (expert colposcopy, biopsy, HPV testing, etc.).
HSIL, ASC-H, AGC-NEO
These findings are a clear reason for a detailed examination of the cervix by a specialist who deals with this issue. Since these findings very often indicate a serious precancerous condition, it is not advisable to take only a follow-up cytology test, but it is necessary to examine the cervix in detail (colposcopy, biopsy).
AGC-NOS
This finding means that the cytology has revealed a slight abnormality. Most likely in the glandular epithelium (the mucous membrane lining the cervical canal). With these findings, a follow-up smear must be performed in 3 to 6 months, ideally after treatment of cervical inflammation, or supplemented with an HPV test as recommended by your doctor.
