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Microbiological Infections in Women With Cervical Cytological Reports of Atypical Squamous Cells of Undetermined Significance

Paba, Pierpaolo PhD1; Criscuolo, Anna Angela MD2; Grazia Giancipoli, Romina MD2; Santi, Flavia MSc3; Ascone, Chiara MD2; Sesti, Francesco MD2; Piccione, Emilio MD2; Perno, Carlo Federico MD1,4; Favalli, Cartesio MD4,5; Ciotti, Marco MD1

Journal of Lower Genital Tract Disease: July 2015 - Volume 19 - Issue 3 - p 203–206
doi: 10.1097/LGT.0000000000000078
Original Articles - Cervix and HPV

Objective: To study the role of cervicovaginal infections in women with cytological reports of atypical squamous cells of undetermined significance (ASC-US).

Materials and Methods: The study included 220 women admitted to the Clinic of Microscopy, Cervicovaginal and Vulvar Pathology of the Department of Gynecology and Obstetrics of the Tor Vergata University Hospital, Rome, Italy, enrolled between October 2012 and July 2013.

Results: Among the enrolled women, 105 women (47.7%) had ASC-US cytology, whereas 115 women (52.3%) had negative cytology. Microscopy showed infections more frequently in women with ASC-US than in those with negative cytology: 70.5% (74/105) vs 36% (41/115); p < .001. Cocci were present in 73.3% (77/105) of the women with ASC-US and in 43.5% (50/115) of those with negative cytology; p < .001. According to Ison score, 84% (88/105) of ASC-US was grade 0 vs 22% (25/115) of negative cytology, p < .001. Human papillomavirus was detected in 35% of the women with ASC-US. A statistically significant correlation between high pH and vaginal infections was found in women aged 20 to 29 (p = .003) and those 50 years or older in both cytological report groups; p < .001.

Conclusions: Cervicovaginal infections are associated with a cytological report of ASC-US. Direct microscopy of vaginal specimens allowing immediate evaluation of the vaginal microflora and infectious agents may be a useful tool in managing women with cytological reports of ASC-US.

Cervicovaginal infections may induce a cytological report of atypical squamous cells of undetermined significance (ASC-US).

1Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Rome, Italy; 2Section of Gynecology and Obstetrics, Department of Surgical Sciences, Polyclinic Tor Vergata Foundation, Rome, Italy; 3Department of Infectious, Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy; 4Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy; and 5Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy

The authors have declared they have no conflicts of interest.

Reprint requests to: Marco Ciotti, MD, Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133 Rome, Italy. E-mail:

Financial support: This work was supported by grants from the Italian National Institute of Health, the Italian Ministry of Instruction University and Research (MIUR), “Progetto FILAS”, and AVIRALIA Foundation.

Copyright © 2015 by the American Society for Colposcopy and Cervical Pathology