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

Abstract

The study was undertaken to investigate whether leukocytes on liquid-based cervical cytology can predict Chlamydia trachomatis infection. A retrospective case-control study of females under 30 years examined the association between leukocytes on liquid-based cervical cytology and C. trachomatis infection. 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. 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.