Meijer C J, Calame J J, de Windt E J, Risse E K, Bleker O P, Kenemans P, Quint W G, Meddens M J
Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
Eur J Clin Microbiol Infect Dis. 1989 Feb;8(2):127-30. doi: 10.1007/BF01963895.
The prevalence of Chlamydia trachomatis infection in a population of women with no symptoms of sexually transmitted disease was investigated. These women, aged 35-55 years, participated in a screening program for cervical cancer. With the use of a direct immunofluorescence method, 109 out of 2,470 smears tested were positive for Chlamydia trachomatis, indicating an overall prevalence of 4.4%. No changes in prevalence were found when five-year cohorts of this group were analyzed, indicating that age-dependent changes or epidemiological factors do not result in a different (decreased) prevalence over the ages 35 to 55 years. The prevalence of Trichomonas vaginalis and fungi, as detected by cytological screening, was lower than that observed for Chlamydia trachomatis: 3.1 and 2.1%, respectively. Of the 109 smears positive for Chlamydia trachomatis, 90 showed cervical cells with reactive changes (out of 1,490 smears with PAP II), whereas no cytological changes were found in 15 cases (out of 884 smears with PAP I). Changes suggestive of mild or moderate dysplasia were found in only four cases (out of 93 smears with PAP III). The results indicate that Chlamydia trachomatis is associated with reactive changes of endocervical cells and raise serious questions about whether prevention of possible secondary effects such as infertility and pelvic inflammatory disease can be achieved by a combined screening program for cervical cancer and Chlamydia trachomatis.
对一群无性传播疾病症状的女性进行了沙眼衣原体感染患病率的调查。这些年龄在35至55岁之间的女性参与了一项宫颈癌筛查项目。采用直接免疫荧光法，在检测的2470份涂片中有109份沙眼衣原体呈阳性，总体患病率为4.4%。对该组五年队列进行分析时未发现患病率有变化，这表明年龄相关变化或流行病学因素不会导致35至55岁年龄段患病率出现不同（降低）情况。通过细胞学筛查检测到的阴道毛滴虫和真菌的患病率低于沙眼衣原体：分别为3.1%和2.1%。在109份沙眼衣原体阳性涂片中，90份显示宫颈细胞有反应性改变（在1490份巴氏Ⅱ级涂片中），而15例未发现细胞学改变（在884份巴氏Ⅰ级涂片中）。仅在4例中发现提示轻度或中度发育异常的改变（在93份巴氏Ⅲ级涂片中）。结果表明，沙眼衣原体与宫颈内膜细胞的反应性改变有关，并引发了关于通过宫颈癌和沙眼衣原体联合筛查项目能否预防诸如不孕和盆腔炎等可能的继发效应的严重问题。
