Inflammation on liquid-based cervical cytology: can leukocytes be used to triage for Chlamydia trachomatis testing?
OBJECTIVE
The study was undertaken to investigate whether leukocytes on liquid-based cervical cytology can predict Chlamydia trachomatis infection.


METHODS
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.


CONCLUSIONS
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.
Donnellan
Nicole M
NM
Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Wiesenfeld
Harold C
HC
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000276:immunology* / Q000473:pathology*; D002692:Chlamydia trachomatis; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008403:Mass Screening; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014626:Vaginal Smears