Age and Peripheral Blood Values Relationship Evaluation of Trichomonas Vaginalis, Candida, and Gardnerella Vaginalis Frequency in Cervicovaginal Pap Smear Screening in Aksaray Province

Abstract

This study aimed to explore the correlation between causative agents of vaginitis detected in Pap smear screenings and various hematological indices, alongside the severity of infections observed in Pap smears. We analyzed 348 Pap smear results, which were categorized into normal and abnormal findings and further subdivided into groups based on the presence of Vulvovaginal Candidiasis (VVC), Bacterial Vaginosis (BV), and Trichomoniasis (TV). The degree of inflammation (mild, moderate, severe) was assessed in relation to hematological indices (Platelet Index Value (PIV), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Lymphocyte to Monocyte Ratio (LMR)), guided by the 2014 Bethesda System for evaluation. Out of 1654 patients screened, 348 met the inclusion criteria (253 aged below 45 years; 95 aged 45 years and above). In the under-45 age group, 83.3% had normal findings, with prevalence rates for VVC, BV, and TV at 73.4%, 60.2%, and 80.0%, respectively. In the over-45 group, these figures were 16.7% (normal), 26.6% (VVC), 39.8% (BV), and 20% (TV). The prevalence of moderate vaginitis in Pap smears was 45.3% for VVC, 96.1% for mild BV, and 53.3% for moderate TV. In cases of Atypical Squamous Cells of Undetermined Significance (ASCUS), BV was predominant, while VVC and TV were absent in Low-Grade Squamous Intraepithelial Lesion (LSIL) and High-Grade Squamous Intraepithelial Lesion (HSIL) cases. BV was present in 7.8% of normal smears. Significant associations were observed between hematological parameters and the severity of inflammation in the normal smear category (p<0.001). In squamous cell anomaly cases, especially ASCUS, differences in SII, NLR, PLR, SIRI, and PIV were noted between severe and mild infections, as well as between moderate and severe infection groups. This research underscores the linkage between the severity of infection and cellular abnormalities identified in cervical cytology, causative agents of vaginitis, and hematological indices with inflammatory parameters, potentially informing clinical management strategies