Kelly B A, Black A S
Br J Gen Pract. 1990 Jun;40(335):238-40.
This study set out to determine whether the term 'inflammatory' in a cervical smear report implies underlying infection or whether it could be masking cancerous or precancerous changes. Of 826 smears taken in one practice over one year, 42 demonstrated some degree of inflammatory change. Thirty four of these women presented for swabs and almost half (47%) had a microbiologically proven infection. This group was further subdivided, and of those whose smears were reported as simple 'inflammation', just over one third (35%) were infected but of those whose smears were reported as 'severe inflammation', over two thirds were infected (73%). The commonest organisms isolated were Gardnerella vaginalis and Candida albicans. It would therefore appear to be worthwhile to treat patients who report severe inflammation with metronidazole and with anti-fungal pessaries before the smear is repeated. Following treatment two women went on to show dyskaryosis within five months. On colposcopy one of these women was found to have invasive cervical squamous cell carcinoma. It is concluded that whether women with inflammatory smears are treated or not, it is mandatory to repeat the smear, ideally within five months.
本研究旨在确定宫颈涂片报告中的“炎症”一词是否意味着存在潜在感染，或者它是否可能掩盖癌性或癌前病变。在一年时间里，一家诊所采集的826份涂片样本中，有42份显示出一定程度的炎症变化。其中34名女性接受了拭子检查，近半数（47%）经微生物学证实存在感染。这组患者进一步细分后发现，涂片报告为单纯“炎症”的患者中，略超过三分之一（35%）受到感染；而涂片报告为“重度炎症”的患者中，超过三分之二（73%）受到感染。分离出的最常见病原体是阴道加德纳菌和白色念珠菌。因此，对于报告为重度炎症的患者，在重复涂片检查之前，先用甲硝唑和抗真菌阴道栓剂进行治疗似乎是值得的。治疗后，有两名女性在五个月内出现了核异质。在阴道镜检查中，其中一名女性被发现患有浸润性宫颈鳞状细胞癌。研究得出结论，无论对有炎症涂片的女性是否进行治疗，都必须重复涂片检查，理想情况下应在五个月内进行。
