title: Uterine cervical ectopy during reproductive age: cytological and microbiological findings.
abstract: Cervical ectopy is common in adolescents, pregnant women, and those taking high doses of estrogen-containing contraceptives. The majority of cases have spontaneous reversion, but some cases can be persistent. Studies suggested that the adequacy of a Pap smear could be affected and there is an increased risk cervical infections. This study is a cross-sectional study conducted from December 2009 to February 2011 with 457 women with cervical ectopy and 736 without ectopy. Cervical samples were collected in vials for analysis by ThinPrep cytology (Hologic, Marlborough, MA). The Mann-Whitney test and Fisher's exact test (95% CI) were applied. The study was approved by the ethics committee of the Federal University of Ceará. The mean ages of the study group and control group were 28.7 (±14.8) and 33.6 (±7.5) years old, respectively (P < 0.0001). Negative diagnosis for malignancy and intraepithelial lesion was present in 399 (87%) cases and 705 (96%) in the study and control groups, respectively (P < 0.0001). Shift in the flora suggestive of bacterial vaginosis (BV) was observed more frequently in the study group: 74 (16.2%) than in the control group: 86(11.7%) (P = 0.017). The differences among the other morphotypes showed no significance. The smears were atypical in 12.7% (58/457) of the patients from the study group and in 4.2% (31/736) in the control group (P < 0.001; RR = 3 [2.033-4.712]). The association between ectopy and inflammatory cytology, the presence of the shift in the flora suggestive of BV and cytological atypia is evident.
authors.affiliation: Maternal and Child Health Department, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: José Eleutério
authors.initials: JE
authors.lastname: Junior
authors.forename: Paulo César
authors.initials: PC
authors.lastname: Giraldo
authors.forename: Ana Katherine Silveira
authors.initials: AK
authors.lastname: Gonçalves
authors.forename: Rose Luce Gomes
authors.initials: RL
authors.lastname: do Amaral
authors.forename: Iara Moreno
authors.initials: IM
authors.lastname: Linhares
mesh_terms: D000293:Adolescent; D000328:Adult; D001421:Bacteria, Anaerobic / Q000254:growth & development; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000382:microbiology / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008853:Microscopy; D065006:Papanicolaou Test; D011247:Pregnancy; D002579:Uterine Cervical Erosion / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*
keywords: cervical ectopy; cervical ectropion; cervical intraepithelial lesion; cervix uteri; thinprep cytology