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🧪 What is PAP Smear – Liquid-Based Cytology (LBC)?

Liquid-Based Cytology (LBC) is a modern version of the PAP smear test used to detect cervical cancer and precancerous lesions. It involves collecting cervical cells and preserving them in a liquid medium, improving sample quality, reducing artifacts, and enabling HPV co-testing from the same sample.

It is now the preferred method over conventional PAP smear in many clinical settings.

❓ Why is the Test Done?

To:

Screen for cervical cancer and CIN (Cervical Intraepithelial Neoplasia)
Detect precancerous changes (LSIL, HSIL)
Identify HPV-related cytologic abnormalities
Co-test for high-risk HPV using the same sample
Detect vaginal infections, inflammatory changes, or hormonal status

🧫 How It’s Done

A speculum is inserted to visualize the cervix.
A brush or spatula is used to collect cells.
Instead of smearing on a slide, the tool is rinsed into a vial containing preservative fluid.
The sample is processed using automated systems to produce thin, uniform slides for cytological evaluation.

📊 Normal & Abnormal Results (Bethesda System)

Result	Interpretation
NILM	Negative for intraepithelial lesion or malignancy
ASC-US	Atypical squamous cells of undetermined significance
LSIL	Low-grade squamous intraepithelial lesion (mild dysplasia)
HSIL	High-grade SIL (moderate/severe dysplasia, CIN 2/3)
AGC	Atypical glandular cells – needs further investigation
SCC/Adenocarcinoma	Indicative of invasive cervical cancer

🧠 Associated Organs & Conditions

System/Organ	Related Conditions
Cervix	CIN, squamous carcinoma, adenocarcinoma
Vagina	Inflammation, atrophy, vaginitis
Hormonal	Atrophic changes in menopause

🔄 Related / Follow-Up Tests

HPV DNA test (can be done on same LBC vial)
Colposcopy and Cervical Biopsy
Endometrial biopsy (for AGC)
Repeat cytology in 6–12 months for ASC-US or LSIL

🔬 Advantages Over Conventional PAP

Aspect	Liquid-Based Cytology	Conventional PAP
Sample quality	Better, clearer	May contain mucus/blood
Multiple tests from vial	✅ HPV, STI testing	❌ Only cytology
Automation	✅ Allows computer screening	❌ Manual only
Detection rate	Higher sensitivity	Moderate sensitivity

✅ Fasting Required?

Test	Fasting Required
LBC PAP Smear	❌ No

But avoid:
✅ Vaginal medications, douching, intercourse, tampons for 24–48 hours prior
✅ Testing during menstruation is discouraged

📝 Summary Table

Parameter	Details
What	Cervical screening using cell suspension in liquid medium
Why	Detect cervical cancer, pre-cancer, HPV-related changes
Normal Result	NILM
Abnormal Findings	ASC-US, LSIL, HSIL, AGC, cancer
Follow-up Tests	HPV DNA test, biopsy, colposcopy
Associated Conditions	CIN, cervical cancer, vaginal infections
Fasting Required	❌ No, but avoid vaginal products/intercourse 48h before test

PAP Smear - Liquid Based Cytology

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