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Inflammation on liquid-based cervical cytology: can leukocytes be used to triage for Chlamydia trachomatis testing?
Nicole M Donnellan1, Harold C Wiesenfeld
1Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Objective:
The study was undertaken to investigate whether leukocytes on liquid-based cervical cytology can predict Chlamydia trachomatis infection.
Study Design:
A retrospective case-control study of females under 30 years examined the association between leukocytes on liquid-based cervical cytology and C. trachomatis infection.
Results:
Smears from chlamydia-infected women had an average of 30.7 leukocytes and a median of 25.4 leukocytes per high-powered field (hpf), whereas smears from controls had an average of 11.5 leukocytes and a median of 7.1 leukocytes per hpf. The median leukocyte to epithelial cell ratio among infected women was 1.4 vs 0.6 in the controls (P < .05). No clear cutpoint of leukocytes to epithelial cells was identified that could serve to detect the maximal number of infected women while minimizing the testing of uninfected women.
Conclusion:
There is an association between inflammation on liquid-based cervical cytology and C. trachomatis infection. However, assessing for leukocytes cannot be recommended as a triage for chlamydia screening, as there is great overlap in inflammation among infected and uninfected women.
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