Aygen ÇELİK, REMZİ ATILGAN, Hatice Banu AYGÜN, ZEHRA SEMA ÖZKAN, Behzat CAN, SALİH BURÇİN KAVAK, Şehmuz PALA, Mehmet Reşat ÖZERCAN

Serviko-vajinal pap smear taramasında trichomonas vaginalis, candida ve gardnerella vaginalis sıklığının yaşa göre değerlendirilmesi

Amaç: Bu çalışmanın amacı pap smear taramasında tespit edilen vajinit etkenlerinin yaş dağılımına göre oranlarını tespit etmektir. Gereç ve Yöntem: Toplam 3831 pap smear tarama sonucu tekrar gözden geçirildi. Patolojik değerlendirmede 2001 Bethesda sistemi kullanıldı. Normal servikal bulgular, inflamasyon, epitelyal hücre anormallikleri ile birlikte Trichomonas vaginalis, Candida türleri, Gardnerella vaginalis gibi vajinit ajanları değerlendirilerek rapor edildi. Bulgular: Toplam 3831 pap smearın 377 ( % 9,8 )' sinde vajinal enfeksiyon ajanı tespit edildi. Etkenler sırası ile 319 ( % 8,3 ) olguda Gardnerella vaginalis, 46 ( % 1,2 ) olguda Candida, 12 ( % 0,3 ) olguda Trichomonas vaginalis idi. Vajinal enfeksiyon ajanlarının tespit edildiği yaş ortalamaları ise sırası ile Gardnerella vaginalis için 37,85± 9,61, Candida için 36,29± 10,05 idi. Trichomonas vaginalis için en küçük yaş 26, en büyük yaş 53, Gardnerella vaginalis için 17- 66, Candida için 23- 65 yaş arasında idi. Sonuç: Pap smear taramasında vajinal enfeksiyon ajanları da tespit edilebilir. Patoloji raporlarında bu ajanların bildirilmesinin, klinik olarak hasta yönetimine katkıda bulunabileceğini düşünmekteyiz.

An evaluation about the frequency of trichomonas vaginalis, candida and gardnerella vaginalis at the serviko-vaginal pap smear examination according to age

Objective: In this study, it is aimed to find the rates of vaginitis determinants identified at the pap smear examination according to age. Materials and Methods: The results of an examination of a total of 3831 pap smears were reviewed. 2001 Bethesda system was used in the pathological evaluation. As well as normal cervical findings, inflamation and epithelial cell abnormalities, vaginit agents such as Trichomonas vaginalis, Candida types and Gardnerella vaginalis were evaluated and reported, too. Results: Vaginal infection agents were found at 377 cases (% 9,8) of a total of 3831 pap smear. The determinants were, respectively, Gardnerella vaginalis in 319 cases (% 8,3), Candida in 46 cases (% 1,2), Trikomonas vaginalis in 12 cases (% 0,3). Age average at cases in which the agent of vaginal infection was identified, was 37,85± 9,61 for Gardnerella vaginalis and 36,29± 10,05 for Candida albicans, respectively. The lowest age was 26 and the maximum age was 53 for Trichomonas vaginalis.It was between the ages of 17-66 for Gardnerella vaginalis, 23-65 for Candida albicans. Conclusion: Vaginal infection agents may be identified in a pap smear examination. We consider that reporting these agents at pathology reports may contribute to the patient management in clinical.

PDF

___

Stewart JA, Kampman O, Huuhka M, et al. ACE polymorphism and response to electroconvulsive therapy in major depression. Neurosci Lett 2009; 458: 122-5.
Solomon D, Davey D, Kurman R, et al. The 2001 Bethesda System. Terminology for reporting cervical cytology. JAMA 2002; 287: 2114-9.
Schwartz PE, Hadjimichael O, Lowell DM, Merino MJ, Janerich D. Rapidly progressive cervical cancer: the Connecti- cut experience. American journal of obstetrics and gynecology 1996; 175: 1105–9.
Özbay K, Yardım T. Servikal lezyonların değerlendirilmesinde colposkopi ve pap smearların etkinliklerinin araştırılması. Jinekoloji ve Obstetrik Dergisi 2005; 19: 228-32.
Sodhani P, Garg S, Bhalla P, et al. Prevalence of bacterial vaginosis in a community setting and role of the pap smear in its detection. Acta Cytol 2005; 49: 634-8.
Giacomini G, Calcani A, Moretti D, Cristofani R. Accuracy of cervical/vaginal cytology in the diagnosis of bacterial vagino- sis. Sex Transm Dis 1998; 25: 24-7.
Nyirjessy P. Vulvovaginal candidiasis and bacterial vaginosis. Infect Dis Clin N Am 2008; 22: 637-52.
Lippman AS, Jones HE, Luppi CG, Pinho AA, Veras MAMS, Van de Wijgert JHHM. Home-based self-sampling and self- testing for sexually transmitted infections: acceptable and fea- sible alternatives to provider-based screening in low-income women in São Paulo, Brazil. Sex Transm Dis 2007; 34: 421-8.
Klomp JM, Boon ME, Van Haaften M, Heintz PM. Cytologically diagnosed Gardnerella vaginalis infection and (pre) neoplasia as established in population-based cervical screening. Am J Obst Gynecol 2008; 199: 480-5.
Lamont RF, Hudson EA, Hay PE, et al. A comparison of the use of Papanicolaoustained cervical cytological smears with Gram-stained vaginal smears for the diagnosis of bacterial va- ginosis in early pregnancy. Int J STD AIDS 1999; 10: 93-7.
Heller DS, Pitsos M, Skurnick J. Does the presence of vaginitis on a Pap smear correlate with clinical symptoms in the patient? J Reprod Med 2008; 53: 429-34.
Murta EFC, Silva AO, Silva EAC, Adad SJ. Frequency of infectious agents for vaginitis in non-hysterectomized womem. Arch Gynecol Obstet 2005; 273: 152-6.
Storti-Filho A, Souza PC, Souza RJ, et al. Prevalence of clue cells suggestive for Gardnerella vaginalis in population-based cervical screening in the public versus private health care in Maringá, Paraná, Brazil Arch Gynecol Obstet 2011; 283: 781- 5.
Monod M, Hube B, Hess D, Sanglard D. Differential regulation of SAP8 and SAP9, which encode two new members of the secreted aspartic proteinase family in Candida albicans. Microbiology 1998; 144: 2731-7.
Og A, Oe O, To A. Sensitivity of a papanicolaou smear in the diagnosis of candida albicans infection of the cervix. North Am J Med Sci 2010; 2: 97-9.
Siapco BJ, Kaplan BJ, Bernstein GS, Moyer DL. Cytodiagnosis of Candida organisms in cervical smears. Acta Cytol 1986; 30: 477-80.
Sardana S, Sodhami P, Agarwal SS, et al. Epidemiological analysis of Trichomonas vaginalis infection in inflammatory smears. Acta Cytol 1994; 38: 693-7.
Plourd DM. Practical guide to diagnosing and treating vaginitis. Medscape Women’s Health 1997; 2: 2.
Ray A, Gulati AK, Pandey LK, Pandey S. Prevalence of common infective agents of vaginitis. J Commun Dis 1989; 21: 241-4.
Toloi MRT, Franceschini SA. Exames colpocitológicos de rotina: Aspectos laboratoriais e patológicos. J Bras Ginec 1997; 107: 251-4.
Adad SJ, de Lima RV, Sawan ZT, et al. Frequency of Trichomonas vaginalis, Candida sp and Gardnerella vaginalis in cer- vical-vaginal smears in four different decades. Sao Paulo Med J 2001; 119: 200-5.
Rivera LR, Trenado MQ, Valdez AC, Gonzalez CJC. Prevalencia de vaginitis y vaginosis bacteriana: associación com manifestaciones clínicas, de laboratório y tratamiento. Ginecy Obst Mex 1996; 64: 26-35.
Tuncer R, Uygur D, Kış S, ve ark. Ankara Zübeyde Hanım Doğumevi 1999-2000 yılları Pap smear sonuçları: 3013 olgunun analizi. Medical Network Klinik Bilimler ve Doktor Kadın Doğum 2003; 9: 94-6.
Karcı E, Beytur L, Karadan M, ve ark. Malatya Devlet Hastanesi Patoloji Laboratuvarına Gelen Smearların Enfeksiyon Ajanları Açısından Değerlendirilmesi. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi 2010; 24: 129-32.