Roeters Anne M E, Boon Mathilde E, van Haaften Maarten, Vernooij F, Bontekoe Tj Romke, Heintz A Peter M
Leiden Cytology and Pathology Laboratory, Leiden 2301 GB, The Netherlands.
Diagn Cytopathol. 2010 Feb;38(2):85-93. doi: 10.1002/dc.21169.
The Dutch cytological coding system, KOPAC, enables to code for eight inflammatory events, that is koilocytosis (related to human papillomavirus (HPV)), Trichomonas, dysbacteriosis [related to bacterial vaginosis (BV)], Candida, Gardnerella, Actinomyces, Chlamydia, and non-specific inflammation (leucocytosis). This study presents an analysis of 1,008,879 smears. Of each smear, the age of the woman and the reason for smear taking (screening or indication) was available. The cytoscores (per mille) for these codes were calculated. For the screening smears, the cytoscores were for koilocytosis (HPV) 2.6, for Trichomonas vaginalis 1.9, for dysbacteriosis 31.4, for Candida albicans 9.8, for Gardnerella vaginalis 0.7, for Actinomyces 6.9, for Chlamydia 0.8, and for non-specific inflammatory changes 66.4. For the calculation of the Odds Ratio (OR), normal smears were used as a reference. The cytoscores for Chlamydia and Gardnerella covaried with high grade SIL (HSIL), with an OR of 7 and 12, respectively. In addition, the OR for Trichomonas vaginalis, for dysbacteriosis, and for leucocytosis proved to be significantly high in the indication smears. This study provides an oversight of HSIL and the full range of cervical infections as detected by cytology, proving that this infectious byproduct of screening can be very valuable.
荷兰细胞学编码系统KOPAC能够对八种炎症事件进行编码，即挖空细胞（与人乳头瘤病毒（HPV）相关）、滴虫、菌群失调[与细菌性阴道病（BV）相关]、念珠菌、加德纳菌、放线菌、衣原体和非特异性炎症（白细胞增多）。本研究对1,008,879份涂片进行了分析。每份涂片都有女性的年龄以及涂片检查的原因（筛查或指征）。计算了这些编码的细胞评分（千分率）。对于筛查涂片，细胞评分分别为：挖空细胞（HPV）2.6、阴道毛滴虫1.9、菌群失调31.4、白色念珠菌9.8、阴道加德纳菌0.7、放线菌6.9、衣原体0.8、非特异性炎症改变66.4。为计算优势比（OR），以正常涂片作为对照。衣原体和加德纳菌的细胞评分与高级别鳞状上皮内病变（HSIL）相关，OR分别为7和12。此外，在指征涂片中，阴道毛滴虫、菌群失调和白细胞增多的OR值显著较高。本研究对HSIL以及细胞学检测出的所有宫颈感染进行了概述，证明这种筛查的感染性副产品可能非常有价值。
