Inflammation on liquid-based cervical cytology: can leukocytes be used to triage for Chlamydia trachomatis testing?

Am J Obstet Gynecol. 2007 May;196(5):e33-5. doi: 10.1016/j.ajog.2006.10.910.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Chlamydia Infections / immunology*
  • Chlamydia Infections / pathology*
  • Chlamydia trachomatis*
  • Female
  • Humans
  • Leukocyte Count*
  • Mass Screening
  • Predictive Value of Tests
  • Retrospective Studies
  • Vaginal Smears