Table of Content

Current Issue

Summer 2021, Vol. 29 No. 2

Hong Kong J. Dermatol. Venereol. (2021) 29, 53-61


Original Article

A cross-sectional study on the relationship between endocervical polymorphonuclear cell counts and chlamydial cervicitis in female patients in Hong Kong

香港女性患者的宮頸內膜多形核白血球細胞計數與衣原體宮頸炎之間關係的橫斷面研究

NM Lau 劉顏銘 and HF Ho 何慶豐

Abstract

Background: The reliability of polymorphonuclear cell (PMN) counts on endocervical smear and non-specific genital infection (NSGI) as a predictor of chlamydial cervicitis remains uncertain. Objectives: To investigate the relationship between endocervical PMN counts, NSGI and chlamydial cervicitis and to identify risk factors and cervical signs associated with chlamydial infection. Methods: The study was conducted in five female Social Hygiene Clinics in Hong Kong from August 2018 to May 2019. The attending doctor collected clinical information and performed speculum examination. Endocervical smears were examined for PMN counts under high-power field. Chlamydia trachomatis infection was diagnosed by nucleic acid amplification test. Results: A total of 556 participants were recruited. After exclusion, statistical analysis was performed on 517 participants. Among them, 16.6% was diagnosed chlamydial cervicitis and 198 (38.3%) fulfilled the criteria of NSGI by endocervical swab. NSGI (OR 4.115; 95% CI 2.244-7.546; p<0.001), age ≤24 (OR 2.000; 95% CI 1.108-3.611; p=0.022), C. trachomatis contact (OR 66.417; 95% CI 18.541-237.912; p<0.001), cervical erythema and oedema (OR 3.016; 95% CI 1.369-6.642; p=0.006) were independently associated with chlamydial cervicitis. The use of NSGI for the detection of chlamydial cervicitis had a positive predictive value (PPV) of 30.3%. Conclusion: With a low PPV, NSGI had limited utility for the prediction of C. trachomatis infection in the clinical setting.

背景:宮頸內膜塗片多形核白血球細胞計數和非特異性生殖器感染作為衣原體宮頸炎的預測因子的可靠性仍不確定。目的:研究宮頸內膜多形核白血球細胞計數、非特異性生殖器感染和衣原體宮頸炎之間的關係,並確定與衣原體感染相關的風險因素和宮頸體徵。方法:本研究於2018年8月至2019年5月在五間女性社會衛生服務診所進行,主治醫生收集臨床資料並進行陰道窺器檢查。在高倍視野下檢查宮頸內膜塗片的多形核白血球細胞計數。通過核酸增幅檢驗確診沙眼衣原體感染。結果:共招募了556名參與者。篩選後,對517名參與者進行了統計分析。其中,16.6%的人被診斷為衣原體宮頸炎,另198人(38.3%)通過宮頸內膜拭子符合非特異性生殖器感染的診斷標準。非特異性生殖器感染(OR 4.115; 95% CI 2.244-7.546; p<0.001)、24歲或以下(OR 2.000; 95% CI 1.108-3.611; p=0.022)、沙眼衣原體接觸史(OR 66.417;95% CI 18.541-237.912;p<0.001)、宮頸紅斑及水腫(OR 3.016;95% CI 1.369-6.642;p=0.006)皆與衣原體宮頸炎獨立相關。使用非特異性生殖器感染查找衣原體宮頸炎的陽性預測值為30.3%。結論:由於陽性預測值較低,非特異性生殖器感染在臨床環境中預測沙眼衣原體感染的效用有限。

Keywords: Chlamydial cervicitis, chlamydial infection, non-specific genital infection, polymorphonuclear cell counts

關鍵詞: 衣原體宮頸炎、衣原體感染、非特異性生殖器感染、多形核白血球細胞計數