Age and Peripheral Blood Values Relationship Evaluation of Trichomonas Vaginalis, Candida, and Gardnerella Vaginalis Frequency in Cervicovaginal Pap Smear Screening in Aksaray Province
Abstract
This study aimed to explore the correlation between causative agents of vaginitis detected in Pap smear screenings and various hematological indices, alongside the severity of infections observed in Pap smears. We analyzed 348 Pap smear results, which were categorized into normal and abnormal findings and further subdivided into groups based on the presence of Vulvovaginal Candidiasis (VVC), Bacterial Vaginosis (BV), and Trichomoniasis (TV). The degree of inflammation (mild, moderate, severe) was assessed in relation to hematological indices (Platelet Index Value (PIV), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Lymphocyte to Monocyte Ratio (LMR)), guided by the 2014 Bethesda System for evaluation. Out of 1654 patients screened, 348 met the inclusion criteria (253 aged below 45 years; 95 aged 45 years and above). In the under-45 age group, 83.3% had normal findings, with prevalence rates for VVC, BV, and TV at 73.4%, 60.2%, and 80.0%, respectively. In the over-45 group, these figures were 16.7% (normal), 26.6% (VVC), 39.8% (BV), and 20% (TV). The prevalence of moderate vaginitis in Pap smears was 45.3% for VVC, 96.1% for mild BV, and 53.3% for moderate TV. In cases of Atypical Squamous Cells of Undetermined Significance (ASCUS), BV was predominant, while VVC and TV were absent in Low-Grade Squamous Intraepithelial Lesion (LSIL) and High-Grade Squamous Intraepithelial Lesion (HSIL) cases. BV was present in 7.8% of normal smears. Significant associations were observed between hematological parameters and the severity of inflammation in the normal smear category (p<0.001). In squamous cell anomaly cases, especially ASCUS, differences in SII, NLR, PLR, SIRI, and PIV were noted between severe and mild infections, as well as between moderate and severe infection groups. This research underscores the linkage between the severity of infection and cellular abnormalities identified in cervical cytology, causative agents of vaginitis, and hematological indices with inflammatory parameters, potentially informing clinical management strategies
Keywords
Ethical Statement
This study has been approved by the Aksaray University Faculty of Medicine Clinical Research Ethics Committee (Ethical Approval Number: 17-SBKAEK/2022/02-06).
References
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Abstract
References
- [1] Solomon D., Davey D., Kurman R., The 2001 Bethesda System. Terminology for reporting cervical cytology, JAMA, 287 (2002) 2114-9.
- [2] Schwartz P.E., Hadjimichael O., Lowell D.M., Merino M.J., Janerich D., Rapidly progressive cervical cancer: the Connecticut experience, American Journal of Obstetrics and Gynecology, 175 (1996) 1105–9.
- [3] Genç Ş. Ö., Erdal H., Are pan-immune-inflammation value, systemic inflammatory response index and other hematologic inflammatory indexes clinically useful to predict first-trimester pregnancy loss, Ann. Clin. Anal. Med., 14(5) (2023) 473-477.
- [4] Erdal H., Yasar E., Tuncer S.Ç., Determination of calprotectin levels in patients with cataract surgery, Ann. Clin. Anal. Med., 14(2) (2023) 148-151.
- [5] Erdal H., Gunaydin F., HALP score for chronic spontaneous urticaria: Does it differ from healthy subjects?, Journal of Experimental and Clinical Medicine, 40(4) (2023) 677-680.
- [6] Nayar R., Wilbur D.C., The Pap test and Bethesda 2014, “The reports of my demise have been greatly exaggerated.” (after a quotation from Mark Twain), Acta Cytol., 59(2) (2015) 121–132.
- [7] Eleutério Jr. J., Campaner A. B., de Carvalho N. S., Diagnosis and treatment of infectious vaginitis: Proposal for a new algorithm, Frontiers in Medicine, 10 (2023) 1040072.
- [8] Leclair C., Stenson A., Common causes of vaginitis, JAMA 327, (2022) 2238–2239.
- [9] Peebles K., Velloza J., Balkus J.E., McClelland R.S., Barnabas R.V., High global burden and costs of bacterial vaginosis, Sex Transm. Dis., 46 (2019) 304–311.
- [10] Denning D.W., Kneale M., Sobel J.D., Rautemaa-Richardson R., Global burden of recurrent vulvovaginal candidiasis: a systematic review, Lancet Infect. Dis., 18 (2018) e339–e347.
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- [13] Fazlollahpour-Naghibi A., Bagheri K., Almukhtar M., Taha S. R., Zadeh M. S., Moghadam K. B., Rostami A., Trichomonas vaginalis infection and risk of cervical neoplasia: A systematic review and meta-analysis, Plos One, 18(7) (2023) e0288443.
- [14] Vieira-Baptista P., Lima-Silva J., Pinto C., Saldanha C., Beires J., Martinez-de-Oliveira J., Donders G., Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities, European Journal of Clinical Microbiology & Infectious Diseases, 35 (2016) 657-664.
- [15] Dahoud W., Michael C. W., Gokozan H., Nakanishi A. K., Harbhajanka A., Association of bacterial vaginosis and human papilloma virus infection with cervical squamous intraepithelial lesions, American Journal of Clinical Pathology, 152(2) (2019) 185-189.
- [16] FuJ., Zhang H., Meta-analysis of the correlation between vaginal microenvironment and HPV infection, American Journal of Translational Research, 15 (2) (2023) 630.
Details
| Primary Language | English |
|---|---|
| Subjects | Metabolic Medicine |
| Journal Section | Natural Sciences |
| Authors | |
| Publication Date | June 30, 2024 |
| Submission Date | November 29, 2023 |
| Acceptance Date | April 19, 2024 |
| Published in Issue | Year 2024 |