SIGNIFICANCE OF INFLAMMATORY CERVICAL SMEARS

Two hundred and fifty-seven women attending a Maternal and Child Healt h Centre (MCH) were examined for different colposcopic and histologica l patterns associated with cervical inflammation as detected by cytolo gy and for their association with different gynaecological infections. The cytodiagnosis revealed inflammation in 207 women (80.5%) and non- inflammation in 49 (19.5%); one smear was inadequate for evaluation. F ifty-six per cent of the women with inflammation and 20% with non-infl ammation had an atypical transformation zone (ATZ), the risk of ATZ be ing 4.9-fold higher in those with inflammation. Biopsies from 128 wome n with abnormal colposcopy revealed morphological changes suggestive o f human papillomavirus (HPV) in 89 (69.5%) and dysplasia of varying gr ades in 8 (6.3%). Seventy per cent of histologically diagno sed HPV le sions stained immunohisto chemically, whereas 84% reacted with a bioti nylated Pan-HPV probe by DNA in situ hybridization (DISH). In addition to HPV, chlamydia (OR 15.6, 95% CI 2.2, 311.6), T. vaginalis (OR 18.4 ), bacterial vaginosis (OR 24.7, 95% CI 3.5, 492) and herpes simplex v irus (OR 4.9, 95% CI 1.4, 20.9) were significantly associated with inf lammatory smears. Of 11 dysplasias detected by colposcopy and confirme d by biopsy, 8 (72.7%) had inflammatory cytology in the initial Pap sm ears. Thus a large proportion of women with inflammatory smears had mu ltiple gynaecological infections and may be at increased risk of devel oping preneoplastic or neoplastic changes. Furthermore, they risk tran smitting the infections to their partners.