Pap test

Definition

巴氏涂片检查主要检查是否有可能演变成 cervical cancer. 在显微镜下检查从宫颈口刮下的细胞. 宫颈是子宫(子宫)的下部，在阴道的顶部打开.

这种检查有时被称为子宫颈涂片检查或子宫颈细胞学检查."

Alternative Names

Papanicolaou test; Pap smear; Cervical cancer screening - Pap test; Cervical intraepithelial neoplasia - Pap; CIN - Pap; Precancerous changes of the cervix - Pap; Cervical cancer - Pap; Squamous intraepithelial lesion - Pap; LSIL - Pap; HSIL - Pap; Low-grade Pap; High-grade Pap; Carcinoma in situ - Pap; CIS - Pap; ASCUS - Pap; Atypical glandular cells - Pap; AGUS - Pap; Atypical squamous cells - Pap; HPV - Pap; Human papilloma virus - Pap cervix - Pap; Colposcopy - Pap; Cervical cytology

How the Test is Performed

你躺在桌子上，把脚放在脚踏板上. 你的医疗保健提供者轻轻地将一个叫做窥镜的仪器插入 vagina to open it slightly. This allows the provider to see the cervix.

Cells are gently collected from the cervix area. 细胞样本被送到实验室检查.

How to Prepare for the Test

Tell your provider if you:

• 曾经有过异常的巴氏试验或阳性的人乳头瘤病毒(HPV)测试. HPV是一种导致生殖器疣和宫颈癌的病毒.
• Might be pregnant.

测试前24小时内不要做以下事情:

• Douche (douching should never be done)
• Have intercourse
• Use tampons

尽量不要把巴氏试验安排在你来月经的时候, but if you are having unexpected bleeding, do not cancel your exam. 你的十大赌博平台排行榜将决定是否还可以做巴氏试验.

为了您的舒适，您可能需要在检查前排空膀胱.

How the Test will Feel

对大多数人来说，巴氏试验几乎不会引起不适. 它会引起一些不适，类似于痛经. You may also feel some pressure during the exam.

You may bleed a little bit after the test.

Why the Test is Performed

巴氏涂片检查寻找宫颈细胞的变化，这些细胞可能会转变为宫颈癌. 如果你按照建议的时间表进行检查，大多数子宫颈癌是可以避免的.

你应该在21岁时开始做巴氏试验，并且每3年做一次.

如果你的年龄在30岁或以上，你可以做以下任何一项:

• Continue to have a Pap test every 3 years
• Switch to a test for HPV every 5 years
• Have both the Pap and HPV tests every 5 years

如果你做过全子宫切除术(子宫和子宫颈切除)，并且过去没有做过异常检查，你可能不需要做巴氏试验.

大多数人在65岁以后可以停止做巴氏试验，如果他们过去做过正常的检查. Ask your provider when you should stop screening.

Normal Results

正常的结果意味着没有异常细胞存在. 巴氏试验不是100%准确的，这就是为什么建议重复检查. Because cervical cancer develops very slowly, 重复巴氏试验通常能在癌症发展之前及时发现治疗的变化.

What Abnormal Results Mean

The most common abnormal Pap test results are:

意义不明的非典型鳞状细胞(ASC-US)

• This test result is considered a mild change.
• These changes may be due to an HPV infection, inflammation, or lack of estrogen as occurs in menopause.
• Repeat Pap testing or HPV testing is recommended. If an HPV test is positive, colposcopy is recommended.

Low-grade squamous intraepithelial lesion (LSIL)

• This test result is considered a mild change.
• 这些变化通常与活动性HPV感染有关，但也可能表明 precancer or cancer is present.
• 建议阴道镜检查，除非HPV检测呈阴性, 在这种情况下，通常建议在一年内重复测试.

非典型鳞状细胞，不能排除HSIL (ASC-H)

• 这个测试结果被认为是一个相对严重的变化.
• 这些变化可能表明存在癌前病变或癌症.
• Colposcopy is recommended.

High-grade squamous intraepithelial lesion (HSIL)

• This test result is considered a severe change.
• 这些变化可能表明存在癌前病变或癌症.
• Colposcopy is recommended.

Atypical glandular cells (AGC)

• This test result is considered a severe change.
• 这些变化可能表明子宫颈或子宫内的细胞有癌前病变或癌症.
• 建议进行阴道镜检查，可能包括子宫内膜活检.

References

Fontham ETH, Wolf AMD, Church TR, et al. 平均风险人群的宫颈癌筛查:美国癌症协会2020年指南更新. CA Cancer J Clin. 2020;70(5):321-346. PMID: 32729638 pubmed.ncbi.nlm.nih.gov/32729638/.

Newkirk GR. 子宫颈抹片检查及有关的子宫颈癌检查技术. In: Fowler GC, ed. 芬宁格和福勒的初级保健程序. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 120.

Perkins RB, Guido RS, Castle PE, et al; 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP异常宫颈癌筛查试验和癌症前体基于风险的管理共识指南. J Low Genit Tract Dis. 2020;24(2):102-131. Erratum in: J Low Genit Tract Dis. 2020;24(4):427. PMID: 32243307 pubmed.ncbi.nlm.nih.gov/32243307/.

Salcedo MP, Phoolcharoen N, Schmeler KM. 下生殖道(宫颈)上皮内瘤变, vagina, vulva): etiology, screening, diagnosis, management. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA等. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 29.

美国预防服务工作队，库里SJ，克里斯特AH，欧文斯DK，等. 宫颈癌筛查:美国预防服务工作组建议声明. JAMA. 2018;320(7):674-686. PMID: 30140884 pubmed.ncbi.nlm.nih.gov/30140884/.