Frequency of Chlamydia trachomatis infection in cervical intraepithelial lesions and the status of cytological p16/Ki-67 dual-staining

Abstract

Background Chlamydia trachomatis (Ct) is not a disease subject to mandatory reporting in Brazil, and the prevalence rate of this genital infection varies according to the region in which studies are conducted, as well as by the detection technique employed. Ct has been associated with persistence of Human papillomavirus (HPV) infection and the facilitation of cervical carcinoma development. We evaluated the Chlamydia trachomatis infection and its association with cytology, p16/Ki-67 dual-stained cytology and cervical intraepithelial lesions status in a screening cohort in Brazil.MethodsThis was a cross-sectional study of 1481 cervical samples from asymptomatic women aged 18 to 64. Samples were collected for liquid-based cytology and Ct detection by polymerase chain reaction. p16/Ki-67 double staining was performed on samples with abnormal cytology. Statistical analysis was by chi-square and likelihood-ratio tests. Odds ratio (OR) and 95% confidence intervals (95% CI) were determined.ResultsThe frequency of Ct was 15.6% and its presence was not associated with detection of p16/Ki-67 [OR = 1.35 (0.5–3.4)]. There was also no association between abnormal cervical cytology and Ct-positivity [OR = 1.21 (0.46–3.2)]. Associations were observed between p16/Ki-67 and high-grade lesions detected by cytology and in biopsies [OR = 3.55 (1.50–8.42) and OR = 19.00 (0.6–7.2), respectively].ConclusionsThe asymptomatic women in our study had a high frequency of Ct infection but this was not associated with p16/Ki-67 detection in samples with abnormal cytology. The expression of p16/Ki-67 was highest in women with high-grade CIN (p = 0.003).

Prevalence of Chlamydia trachomatis Infection, Serovar Distribution and Co-Infections with Seven High-Risk HPV Types among Italian Women with a Recent History of Abnormal Cervical Cytology

“…Chlamydia trachomatis and HPV co-infections in that study were found to occur in 4.9% and 9.3% of patients with and without cervical cytology abnormalities, respectively. The prevalence of both HPV infections and HPV/Ct co-infections found in our study is included in the spectrum of rates previously reported in the literature [9,10,14,19,20,21,24,25,26,27,28,29,30]. This variability depends on the type of population studied, the methods used for HPV detection, and the HPV types being investigated.…”

Meta‐analysis of the accuracy of p16 or p16/Ki‐67 immunocytochemistry versus HPV testing for the detection of CIN2+/CIN3+ in triage of women with minor abnormal cytology

“…Twenty studies reported the accuracy of p16, among which 1 study also evaluated dual staining. Eighteen studies evaluated the accuracy of dual staining only. The positivity criteria for p16 staining varied across the studies.…”

“…Eight studies used the nuclear scoring system of Wentzensen et al For 1 study, the p16 positivity cutoff was brown cytoplasmic staining for p16 in more than 10 cervical cells. With respect to dual staining, 19 studies considered simultaneous red nuclear and brown cytoplasmic staining of at least 1 cervical cell as a positivity criterion.…”

Microbiome and Cervical Cancer

“…Vaginal acidity prevents colonization by anaerobes, maintains the cervical epithelial barrier through production of bacteriocins, and acts against mucin degradation, keeping away opportunistic infections [21]. As mentioned before, lactic acid production inhibits the growth of several anaerobic agents associated with sexually transmitted diseases that may contribute to the progression of cervical lesions when associated with hrHPV persistence [93]. Infection by C. trachomatis seems to increase the risk of hrHPV infection of CC through an inflammatory response, which increases ROS production and free radicals [94].…”