Cervical cytology as a diagnostic tool for female genital schistosomiasis: Correlation to cervical atypia and Schistosoma polymerase chain reaction.
Cervical cytology as a diagnostic tool for female genital schistosomiasis: Correlation to cervical atypia and Schistosoma polymerase chain reaction.
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DOI：
10.4103/1742-6413.180784
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发表时间：
2016
期刊：
影响因子：
1.9
通讯作者：
Kjetland EF
中科院分区：
文献类型：
--
作者：
Pillay P;van Lieshout L;Taylor M;Sebitloane M;Zulu SG;Kleppa E;Roald B;Kjetland EF
女性生殖器血吸虫病（FGS）是一种由埃及血吸虫虫卵滞留在生殖器粘膜的组织反应。病变可使粘膜脆弱，易于出血和分泌物。患有FGS的女性可能会增加获得HIV的风险，并且FGS可能是宫颈癌发展的辅助因素。探讨细胞学作为诊断FGS的方法，并讨论在资源匮乏的农村地区诊断的挑战。FGS与鳞状细胞癌（SCA）之间的相关性也进行了探讨和讨论。将细胞学结果与阴道灌洗液、尿液和尿液显微镜检查中的血吸虫聚合酶链反应（PCR）进行比较。在一项临床研究中，来自南非夸祖鲁-纳塔尔农村高中的394名年龄在16至23岁之间的妇女接受了结构化访谈和以下实验室检查：血吸虫卵和宫颈SCA，阴道灌洗液和尿液样品中血吸虫特异性DNA的实时PCR，以及尿液显微镜检查是否存在S.埃及血吸虫卵在巴氏涂片中，S. 8/394例（2.0%）检出埃及血吸虫卵。107/394例（27.1%）发现SCA，其中7例为高度鳞状上皮内病变（HSIL）。38/394（9.6%）阴道灌洗液和91/394（23.0%）尿液中检出血吸虫特异性DNA。在78/394（19.7%）的尿液中发现了显微镜下的卵子。血吸虫灌洗PCR是诊断FGS较细胞学更好的方法。S.巴氏涂片和其他诊断方法中的埃及血吸虫卵。在低资源血吸虫病流行地区，重要的是，细胞学筛查人员意识到除了SCA的细胞学诊断外，血吸虫病的诊断挑战。重要的是，在这项研究中，八分之三的尿液呈阴性，但在巴氏涂片中显示血吸虫卵，其中一人尿液中的血吸虫DNA也呈阴性。在这项研究中，SCA与血吸虫病无显著相关。在这一年轻人群中发现的HSIL可能需要进一步考虑。
Female genital schistosomiasis (FGS) is a tissue reaction to lodged ova of Schistosoma haematobium in the genital mucosa. Lesions can make the mucosa friable and prone to bleeding and discharge. Women with FGS may have an increased risk of HIV acquisition, and FGS may act as a cofactor in the development of cervical cancer. To explore cytology as a method for diagnosing FGS and to discuss the diagnostic challenges in low-resource rural areas. The correlation between FGS and squamous cell atypia (SCA) is also explored and discussed. Cytology results are compared to Schistosoma polymerase chain reaction (PCR) in vaginal lavage and urine and in urine microscopy. In a clinical study, 394 women aged between 16 and 23 years from rural high schools in KwaZulu-Natal, South Africa, underwent structured interviews and the following laboratory tests: Cytology Papanicolaou (Pap) smears for S. haematobium ova and cervical SCA, real-time PCR for Schistosoma-specific DNA in vaginal lavage and urine samples, and urine microscopy for the presence of S. haematobium ova. In Pap smears, S. haematobium ova were detected in 8/394 (2.0%). SCA was found in 107/394 (27.1%), seven of these had high-grade squamous intraepithelial lesion (HSIL). Schistosoma specific DNA was detected in 38/394 (9.6%) of vaginal lavages and in 91/394 (23.0%) of urines. Ova were found microscopically in 78/394 (19.7%) of urines. Schistosoma PCR on lavage was a better way to diagnose FGS compared to cytology. There was a significant association between S. haematobium ova in Pap smears and the other diagnostic methods. In low-resource Schistosoma-endemic areas, it is important that cytology screeners are aware of diagnostic challenges in the identification of schistosomiasis in addition to the cytological diagnosis of SCA. Importantly, in this study, three of eight urines were negative but showed Schistosoma ova in their Pap smear, and one of them was also negative for Schistosoma DNA in urine. In this study, SCA was not significantly associated with schistosomiasis. HSIL detected in this young population might need future consideration.