What Do Squamous Metaplastic or Endocervical Cells on a Pap Smear Indicate?
“Some questions and concerns may be raised by seeing endocervical cells on your Pap smear test results. The presence of these cells isn’t usually a cause for concern”
The phrase “endocervical cells present” means that your doctor took cells from the inside of your uterus during the Pap smear. The pathologist who examined your Pap smear found cells that were growing and repairing themselves regularly, which is what the phrase means.
In this article, we take a look at squamous and endocervical cells and what they mean on a Pap smear test result. We also decode the meaning of other terms that may show up on a Pap test. Read on.
There are different types of cells in your body.
- Your skin is very young.
- The outer surface of the uterus.
- The linings of your organs.
Metaplastic is the term used to describe changes within these thin, flat-shaped cells.
Most cancers of the cervix and vagina are
Atypical squamous cells of undetermined significance (ASC-US)
If the pathologist finds atypical squamous cells of unknown significance, this usually means that they have found irregular cells and could not determine why they were irregular.
This could mean that you have an HPV infection, in which case your doctor will need to conduct further testing for HPV to confirm. The irregular cells could also be due to other inflammatory or noncancerous changes of the cervix that will likely resolve on their own.
Squamous intraepithelial lesions (SIL)
The Pap test shows cells that are precancerous or more likely to turn into cancer. These may be further classified as low-grade or high-grade, indicating a low to high risk of cancer development.
In the case of HSIL, your doctor may recommend further examination of these cells using a colposcopy.
A colposcopy is a procedure that allows a doctor to examine your cervix using a colposcope. They can take tissue samples that can be sent to a lab for further examination.
The inner cervix contains mucus-production glandular cells. Your doctor or nurse may take a sample of these cells during a Pap smear, but not always.
If your Pap smear results doshow that endocervical cells are present, it means that your test included cells from your endocervix as part of the sample examined under a microscope. It’s standard to have endocervical cells, and their presence does not indicate cancer or precancer.
If your Pap smear shows cancer cells, it may be a sign of a different type of cancer. The two most common types of cancer in the cervix are edanocarcinoma and squamous cell carcinoma.
Your doctor will most likely recommend a colposcopy to examine these areas in more detail and collect tissue samples.
It can be concerning to see codes and phrases that are not clearly defined, even if your Pap smear results show a standard result. It is helpful to understand what your Pap test results show so that you can have a discussion with your doctor.
Below is a breakdown to help you decode common phrases you may see on both a standard and irregular Pap test result:
Phrases associated with standard results
|Phrase||What it means|
|endocervical cells present||a healthcare professional sampled some of the mucus-producing glandular cells located within your inner cervix and found
|endocervical cells absent||no endocervical cells were collected during your Pap smear|
|endometrial cells present||cells from your endometrium were collected during your Pap smear|
|squamous metaplastic cells present||changes within cervical squamous cells were seen but without any concerning irregularities|
|negative for intraepithelial lesions or malignancy (NILM)||no signs of malignancy or lesions were noted|
|acute inflammation||this may indicate the presence of white blood cells in your sample|
|transformation zone component absent/present||this indicates whether cells were collected within the cervical canal|
|atrophic changes||your cervix may be exhibiting signs of menopause|
Phrases that may mean you need further testing
|Phrase||What it means|
|atypical squamous cells of uncertain significance (ASC-US)||changes within squamous cells on the outside of your cervix that may indicate an HPV infection or be due to other inflammatory or noncancerous changes of the cervix that will likely resolve on their own|
|low-grade squamous intraepithelial lesion (LSIL)||indicates lower-risk cervical cell changes|
|high-grade squamous intraepithelial lesion (HSIL)||cervical cell changes are present and may be at a higher risk of turning into cancer|
|atypical squamous cells (ASC-H)||changes were found within the squamous cells of your cervix, and you may also have HSIL|
|atypical glandular cells (AGC)||changes within the glandular cells of the endocervix exhibit possible signs of precancer or cancer|
|endocervical adenocarcinoma||indicates cancerous cells of the endocervix|
|endometrial/extrauterine adenocarcinoma||presence of cancerous cells in the endometrium, ovaries, or fallopian tubes|
|adenocarcinoma, unspecified||cancer cells of an unknown site of origin|
If your Pap smear results are standard, you do not need to take any further action. Unless told otherwise by your doctor, you may stick to your regular Pap testing schedule.
On the other hand, if any irregularities are found, your doctor will likely order further testing. According to the
- A physical exam.
- Blood testing.
- a follow-up Pap test in
- Testing for the human immunodeficiency virus.
- colposcopy to examine the cervix, especially if your HPV test is positive
- cervical biopsies, which consist of tissue samples taken directly from the cervix for further lab testing
How often should you have a Pap smear?
The general guidelines for Pap smears are as follows:
- Ages 21 to 29. Every 3 years.
- Ages 30 to 64. Every 3 years or a combination of Pap and Testing for the human immunodeficiency virus. every 5 years.
- Age 65 and older. Your doctor may recommend that you stop having regular Pap smears if you have never had an irregular result and have had at least two negative tests in a row.
If you’ve recently had an irregular Pap smear or are considered to be at high risk for cervical cancer, your doctor may recommend more frequent testing.
You should also still see your OB-GYN annually. Pap smear guidelines change often, and your doctor can let you know if and when you need a Pap smear or other gynecological testing.
Most medical professionals will tell you that your Pap smear test results were standard or that you need to have further testing to confirm possible anomalies.
Discuss your Pap smear results with your doctor. Follow any next steps and further testing recommendations.
Screenings for cervical cancer detect precancer and cancer cells for the earliest possible treatment.