Assessment of the Association of Vaginal Infection with Atypical Pap-smear Results

Abstract

Introduction: This study aims to evaluate the frequency of infectious agents in Pap-smear results and their association with pathological results. Materials and Methods: This retrospective study was conducted by evaluating the smear results between January 1, 2021 and December 31, 2021 at the Tuzla State Hospital. Smear results were classified according to the Bethesda system [normal, atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells-high-grade (ASC-H), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), atypical glandular cells (AGC) carcinoma]. In addition, vaginitis agents (Trichomonas vaginalis, Gardnerella vaginalis, Candida spp., Actinomyces spp.) found in the report were also recorded separately. Results: In the study, as a result of the evaluation of 4708 smear results, a vaginal infectious agent was found in 675 patients (16.55%). G. vaginalis was observed most frequently in 322 patients (7.9%), and the Candida spp. was observed in 298 patients (7.3%). Actinomyces spp. was observed in eight patients and T. vaginalis was observed in two patients. Pathology results were normal in 4129 (87.7%) according to the 2014 Bethesda system. Five hundred and fifty (11.68%) of them were ASC-US, nine (0.19%) ASC-H, 17 (0.36%) LSIL, and three (0.06%) were reported as HSIL. G. vaginalis was accompanied in 29 of the ASC-US results, and Candida spp. accompanied 10. Candida spp. was observed in 2 of 9 patients diagnosed with ASC-H, and G. vaginalis was observed in one of them. G. vaginalis was found in 1 of 17 patients diagnosed with LSIL, and no infection was found in three patients diagnosed with HSIL. Conclusion: Routine Pap-smear examination is essential for identifying cervicovaginal infectious agents as well as cervical pathologies.