Possibilities of detection of non-viral pathogens causing sexully transmitted diseases by means of cytological analysis of VCE-smears stained by Papanicolaou

Abstract

U Papanicolaou- razmazu se od nevirusnih uzročnika spolno prenosivih bolesti opisuju Chlamydia trachomatis, Gardnerella vaginalis, Trichomonas vaginalis i fungi. Citološka dijagnozaa Chlamydiae trachomatis na osnovi intracitoplazmatskih inkluzija i pratećeg upalnog eksudata s osjetljivsti od 0 do 54% i specifičnosti 5 95% nije dovoljno specifična da omogući razlikovanje od drugih infekcija. Dijagnoza infekcije Gardnerellom vaginalis na osnovi nalaza tzv. "clue cells" ima osjetljivost od 49 do 90%, specifičnost od 97 do 100% i pozitivnu prediktivnu vrijednost od 90 do 97%, pa može koristiti za detekciju i dijagnozu koju nije potrebno mikrobiološki verificirati. Identifikacija protozoa u razmazu prilikom infekcije trihomonassom daje citologiji osjetljivost od 56 do 92% i specifičnost između 83-99%, te ima važnu ulogu u detekciji asimptomatske infekcije, s tim da je prije terapije potrebna potvrda nalaza. Identifikacija spora i pseudomicelija u dijagnozi gljivične infekcije daje razmazu osjetljivost od 3 do 49%, specifičnost od 98 do 100%, pozitivnu predikativnu vrijednost od 20 do 100% i negativnu prediktivnu vrijednost od 71 do 85%.Non-viral pathogens causing sexually transmitted diseases, found in Papanicolaou smears, include Chlamydia trachomatis, Gardenella vaginalis, Trichomonas vaginalis and fungi. Cytological diagnosis of Chlamydia trachomatis by means of intracytoplasmic inclusion and inflammatory exudate with the sensitivity of 0-54% and specificity of 5-59% is not specific enough to enable the differentiation from other infections. The diagnosis of Gardenella vaginalis infections by means of "clue-cells" finding has the sensitivity of 49-90%, specificity of 97 - 100% and the predictive value of 90-97%, making it usable for detection and diagnosis not required to be verified microbiologically. Identification of protozoa in the smear in Trichomonas vaginalis infection indicates the cytological sensitivity to be 56-92% and the specificity 83-99%, thus playing a significant role in the detection of asymptomatic infection; however, verification of the finding is necessary before therapy. Identification of spores and pseudomycelium in the diagnosis of fungal infection indicates the sensitivity of smear of 3:49%, specificity of 98-100%, positive predictive value of 20-100% and negative predictive value of 71-85%