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Yang, Jeong, and Kim: The study of association between human papillomavirus and Chlamydia trachomatis infection in cervical intraepithelial neoplasia
Original Article
Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(12): 1100-1109.

Published online: 21 December 2010

DOI: https://doi.org/10.5468/kjog.2010.53.12.1100

The study of association between human papillomavirus and Chlamydia trachomatis infection in cervical intraepithelial neoplasia

Jung-Sun Yang, M.D., Yun-Hee Jeong, M.D., Jong-Soo Kim, M.D.

Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea.

Corresponding author (soo8541@hanmail.net)

Received 21 July 2010       Revised 18 October 2010       Accepted 17 November 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

The aim of this study is to comparing the prevalence and correlationships between human papillomavirus (HPV) and Chlamydia trachomatis (CT) infection in cervical samples among women with abnormal cervical cytology.

Methods

This study was included three hundred seventy four patients with a abnormal liquid-based cytology in Dankook University hospital. All of them underwent HPV DNA test and CT analysis with polymerase chain reaction. All patients also went through colposcopic directed cervical biopsies or Loop Electrosurgical Excision Procedure, conization. The histo-pathologic results were classified as normal, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and carcinoma in situ (CIS).

Results

Abnormal liquid-based cytology patients were pathologically proven to have CIN. Among 374 patients, the number of within normal limits (chronic cervicitis) and koilocytosis was 186 cases (49.7%), CIN 1, 64 cases (17.1%), CIN 2 16 cases (4.3%) CIN 3, 55 cases (14.7%), and CIS, 53 cases (14.2%). HPV DNA positive patients were 235 cases and HPV DNA negative patients were 139 cases. The impact of CT infection seems not to interfere with the development or even the progression of CIN. Thirty one patients had positive infection of CT (8.3%) and 343 patients were negative infection of CT (91.7%). Both HPV and CT positive infected patients were 25 cases (6.7%) in abnormal cytologic women. The correlation between HPV and CT DNA positive among women with abnormal cytology was statistically significant. (P=0.022)

Conclusion

This study suggests that CT infection is associated with HPV infection, but the clinical significance of the association between CT and HPV infection remains to be elucidated.

Keywords: Cervical intraepithelial neoplasia, Human papilloma virus, Chlamydia trachomatis, Liquid-based cytology

Figures and Tables

Fig. 1
Species-specific DNA amplification by multiples polymerase chain reaction in clinical specimens. M: STD6 marker: Trichomonas vaginalis (580 bp), Mycoplasma hominis (502 bp), Ureaplasma urealyticum (435 bp), Chlamydia trachomatis (348 bp), Mycoplasma genitalium (253 bp), Neisseria gonorrhoeae (214 bp). N: negative. 1~6: clinical samples.
Sample 1 Trichomonas vaginalis, Chlamydia trachomatis.
Sample 2 Ureaplasma urealyticum.
Sample 3 Mycoplasma hominis, Chlamydia trachomatis.
Sample 4 Neisseria gonorrhoeae.
Sample 5 Mycoplasma genitalium.
Sample 6 Ureaplasma urealyticum, Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae.
kjog-53-1100-g001
Table 1
Histologic diagnosis of each abnormal liquid-based cytology result
kjog-53-1100-i001

ASCUS: atypical squamous cells of undetermined significance, LSIL: low-grade squamous intraepitheilal lesion, HSIL: high-grade squamous intraepitheilal lesion CIN: cervical intraepitheilal neoplasia, CIS: carcinoma in situ.

Table 2
Correlation between cytopathological results and type specific HPV DNA in abnormal cervical cytologic women
kjog-53-1100-i002

High risk type: 16, 18, 31, 33, 35, 39, 45, 51, 56, 58, 59, 68. Low risk type: 6, 11, 34, 40, 42, 43, 44, 70.

HPV: human papillomavirus, DNA: deoxyribonucleic acid, CIN: Cervical intraepitheilal neoplasia, CIS: carcinoma in situ.

* Pearson chi-square test.

Table 3
Correlation between cytopathological results and C. trachomatis DNA detection
kjog-53-1100-i003

DNA: deoxyribonucleic acid, HPV: human papillomavirus, CT: Chlamydia trachomatis, CIN: cervical intraepithelial neoplasia, CIS: carcinoma in situ.

* Pearson chi-square test.

Table 4
Correlation between cytopathological results and HPV and C. trachomatis co-infection
kjog-53-1100-i004

HPV: human papillomavirus, CT: Chlamydia trachomatis, DNA: deoxyribonucleic acid, CIN: cervical intraepithelial neoplasia, CIS: carcinoma in situ.

* Pearson chi-square test.

Table 5
The correlation between HPV and C. trachomatis DNA positive among women with abnormal cytology
kjog-53-1100-i005

HPV: human papillomavirus, DNA: deoxyribonucleic acid.

* Pearson chi-square test.

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