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Significance of inflammatory cervical smears
Author(s) -
Parashari ADITYA,
Singh VEENA,
Gupta MADAN M.,
Satyanarayana L.,
Chattopadhya D.,
Sodhani PUSHPA,
Sehgal ASHOK
Publication year - 1995
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1699-0463.1995.tb01106.x
Subject(s) - colposcopy , medicine , dysplasia , bacterial vaginosis , cytology , inflammation , biopsy , chlamydia , vaginitis , endometritis , carcinoma in situ , pathology , gynecology , cervical cancer , carcinoma , pregnancy , immunology , cancer , biology , genetics
Two hundred and fifty‐seven women attending a Maternal and Child Health Centre (MCH) were examined for different colposcopic and histological patterns associated with cervical inflammation as detected by cytology and for their association with different gynaecological infections. The cytodiag‐nosis revealed inflammation in 207 women (80.5%) and non‐inflammation in 49 (19.5%); one smear was inadequate for evaluation. Fifty‐six per cent of the women with inflammation and 20% with non‐inflammation had an atypical transformation zone (ATZ), the risk of ATZ being 4.9‐fold higher in those with inflammation. Biopsies from 128 women with abnormal colposcopy revealed morphological changes suggestive of human papillomavirus (HPV) in 89 (69.5%) and dysplasia of varying grades in 8 (6.3%). Seventy per cent of histologically diagnosed HPV lesions stained immunohistochemically, whereas 84% reacted with a biotinylated Pan‐HPV probe by DNA in situ hybridization (DISH). In addition to HPV, chlamydia (OR 15.6, 95% CI 2.2, 311.6), T. vaginalis (OR 18.4), bacterial vaginosis (OR 24.7, 95% CI 3.5, 492) and herpes simplex virus (OR 4.9, 95% CI 1.4, 20.9) were significantly associated with inflammatory smears. Of 11 dysplasias detected by colposcopy and confirmed by biopsy, 8 (72.7%) had inflammatory cytology in the initial Pap smears. Thus a large proportion of women with inflammatory smears had multiple gynaecological infections and may be at increased risk of developing preneoplastic or neoplastic changes. Furthermore, they risk transmitting the infections to their partners.