An evaluation of infectious diseases in cervicovaginal smears from patients with atypical cells of undetermined significance

Abstract

Despite all studies of infectious disease of the female genital tract, there have been a few studies of the many different types of infectious organisms on Pap smears that contain abnormal cells. The purpose of this study is to evaluate the significance of infectious organisms in women with a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS). This study utilizes 398 cervicovaginal smears and concurrent cervical biopsies (test and control cases) obtained from the Department of Health cases from January to December 1993 and 1995. The cases were randomized, assigned a study number and reviewed for the presence of infectious organisms. The age range for the patients consisted of 15 to 62 for the ASCUS test group (mean 24) and 13 to 64 for the matched control group (mean 24). The results of the microscopic review were entered into SPSS for evaluation. Infectious organisms were identified in 101 (25.4%) of the test and control cases. The type of organisms identified in the ASCUS and matched control cases were normal vaginal flora 42 (21.2) and 48 (24.0%), Actinomyces one (.3%) case, Candida albicans in 2 (1%) and 4 (2%), Trichomonas vaginalis in 10 (5.1%) and 9 (4.5%). Herpes virus effect was not identified in the test cases but was identified in 2 of the control cases. The cytopathic effect of human papilloma virus was identified in 68 (34.3) and 3 (1.5%) of the test cases. Data collected in this study indicate that infectious organisms, other than the effect of the human papilloma virus, are not as common in the ASCUS cases as the matched control cases. Human papilloma virus effect was more commonly associated with the squamous intraepithelial lesions.