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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.

American Journal of Obstetrics and Gynecology
|May 1, 2007
PubMed

Insights

Inflammation detected by leukocytes on cervical cytology is associated with Chlamydia trachomatis infection. However, it cannot reliably predict infection and is not recommended for chlamydia screening triage.

Area of Science:

  • Gynecologic Pathology
  • Infectious Diseases
  • Cytopathology

Background:

  • Cervical cytology is a routine screening tool for precancerous cervical changes.
  • Inflammation, indicated by leukocytes, can be observed on liquid-based cervical cytology (LBC) smears.
  • Chlamydia trachomatis is a common sexually transmitted infection with significant public health implications.

Purpose of the Study:

  • To investigate the predictive value of leukocytes on LBC for Chlamydia trachomatis infection.
  • To determine if leukocyte counts or ratios in LBC can serve as a triage method for chlamydia screening.

Main Methods:

  • A retrospective case-control study was conducted.
  • The study included females under 30 years of age.
  • The association between leukocytes on LBC and C. trachomatis infection was examined.

Main Results:

  • Women with C. trachomatis infection showed significantly higher average (30.7 vs 11.5) and median (25.4 vs 7.1) leukocyte counts per high-powered field (hpf) compared to controls.
  • The median leukocyte to epithelial cell ratio was higher in infected women (1.4) than in controls (0.6) (P < .05).
  • No definitive cut-off for leukocytes or their ratio effectively identified infected women while excluding uninfected ones.

Conclusions:

  • An association exists between cervical inflammation observed on LBC and C. trachomatis infection.
  • Leukocyte assessment on LBC is not recommended as a triage strategy for chlamydia screening due to significant overlap between infected and uninfected groups.
  • Further research may be needed to identify more specific biomarkers for chlamydia screening.
Abstract

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