Correlation and clinical significance of VISTA expression and cervical squamous cell carcinoma / 中华肿瘤杂志

Objective: To explore the relationship between the expression of the T-cell activation suppressor-immunoglobulin variable region (VISTA) and the development of cervical squamous cell carcinoma (CSCC), and the impact on the prognosis of CSCC patients. Methods: Cervical tissue samples from 116 CSCC, including 23 cervical intraepithelial neoplasia (CIN) grade I, 23 CIN grade Ⅱ-Ⅲ, and 23 chronic cervicitis patients, were collected from the First Hospital of Soochow University between March 2014 and April 2019. The expression of VISTA in each group was detected by immunohistochemistry (IHC). Survival data of CSCC patients were obtained by follow-up. The survival analysis was performed by Kaplan-Meier method, and survival differences between groups were compared by Log rank test. Prognostic impact factors were analyzed using a multifactorial Cox proportional hazards model. Results: The positive rate of VISTA expression in CSCC group was 32.8% (38/116), and which of grade Ⅱ-Ⅲ was 17.4% (4/23). VISTA expression results showed no positive expression patients in the cervical intraepithelial neoplasia grade I and chronic cervicitis groups. The differences between the CSCC group and other groups were statistically significant (P<0.01). In 116 CSCC patients, VISTA expression was associated with International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis (P<0.01). The mean survival time of patients in the VISTA positive expression group was 30.7 months, and the 3-year survival rate was 44.7% (17/38). However, the mean survival time of the patients in the VISTA negative expression group was 49.1 months, and the 3-year survival rate was 87.2% (68/78). The Cox regression model found that VISTA expression positivity (P=0.001) and FIGO stage (P=0.047) were prognostic factors for CSCC, and patients with VISTA-positive CSCC had a 4.130-fold risk of death higher than those with VISTA-negative expression. Conclusions: The VISTA protein is highly expressed in CSCC tissues, and its expression level is closely related to the occurrence and development of CSCC. The expression of VISTA can be used as an independent predictor of CSCC prognosis and can provide a strong basis for the treatment of CSCC with immune checkpoint inhibitors.

Cervicitis necrótica por co-infección de virus herpes simplex 2 y Mycoplasma genitalium / Necrotic cervicitis for co-infection of herpes simplex virus 2 and Mycoplasma genitalium

Resumen Las cervicitis es una condición frecuente causada principalmente por agentes de transmisión sexual. Su presentación clínica varía desde cuadros asintomáticos hasta procesos inflamatorios extensos, que incluso asemejan un tumor maligno. Presentamos el caso de una adolescente que presentó úlceras genitales, síntomas generales y cérvix necrótico con aspecto tumoral. Los estudios de laboratorio confirmaron una co-infección por virus herpes simplex 2 (HSV-2) y Mycoplasma genitalium. El estudio histológico descartó una neo- plasia. Evolucionó favorablemente al tratamiento antimicrobiano, con recuperación progresiva del aspecto del cérvix. La cervicitis en raras ocasiones se presenta con compromiso necrótico. La co-infección por HSV-2 y M. genitalium, en este caso, pudo ser el determinante del daño cervical y la necrosis. Una evaluación acuciosa y estudio con exámenes diagnósticos de alta sensibilidad y especificidad permitieron hacer un diagnóstico y tratamiento adecuado.

Abstract Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.

Estudio Descriptivo: Colposcopia en el diagnóstico de lesiones de cuello uterino en el Hospital de Especialidades José Carrasco Arteaga, Cuenca ­ Ecuador. 2015-2019 / Descriptive Study: Colposcopy as a diagnostic method for cervix lesions in Hospital de Especialidades Jose Carrasco Arteaga, Cuenca-Ecuador. 2015-2019

INTRODUCCIÓN: El cáncer de cuello uterino es un problema de salud pública, siendo una de las principales causas de morbilidad y mortalidad en países en vía de desarrollo. Para el screening y diagnóstico de las lesiones del cuello uterino se realiza citología cervical (Papanicolaou). Ante un reporte de citología sospechosa, la colposcopia es un procedimiento imprescindible en la evaluación del tracto genital inferior para detectar lesiones tempranas y cáncer. El objetivo de la presente investigación fue caracterizar los procedimientos colposcópicos realizados, como método diagnóstico y terapéutico, en las pacientes con resultados anormales del Papanicolaou. MATERIALES Y MÉTODOS: El presente es un estudio observacional, descriptivo de corte transversal, cuyo universo lo conformaron todas las pacientes con diagnóstico citológico anormal en Papanicolaou, que se realizaron un procedimiento colposcópico entre el año 2015 hasta el año 2019 en el Hospital José Carrasco Arteaga, con un total de 1 628 pacientes. RESULTADOS: Se incluyen 1 628 procedimientos colposcópicos. El 55.46% de la población estuvieron entre los 27 a 46 años de edad. El estado civil predominante fue casada (75%). El 63.45% de las mujeres iniciaron vida sexual entre los 21 a 30 años. El 95.20% de las pacientes tuvieron entre 1 y 3 parejas sexuales. Los resultados de Papanicolaou anormales representan; el 37.28% a LIE-BG, seguido de 35.81% con ASC-US y 14.18% como LIE-AG. El 67.32% de colposcopías fueron satisfactorias. Se realizó biopsia en el 71% de las pacientes, seguido de la toma de muestra de cono con ASA-LEEP (13.69%), legrado endocervical en el 11.05%. Los resultados de anatomía patológica reportaron LIE-AG en 46.56% de los casos, seguido de 22.23 % como LIE-BG y cervicitis crónica en el 16.27%, 12.28% de los resultados fueron negativos. CONCLUSIÓN: Tres cuartas partes de las colposcopias se realizaron en mujeres entre los 27 y 56 años de edad. Los resultados anormales más frecuentemente encontrados en el Papanicolaou fueron: LIE-BG, seguido de ASC-US. 67% de las colposcopias realizadas fueron satisfactorias. Tras la colposcopia, en la mayoría de pacientes se realizó biopsia, en un menor porcentaje y en orden de frecuencia: conización electro quirúrgica con asa (ASA-LEEP), legrado endocervical e histerectomía diagnóstica. Los resultados de anatomía patológica reportaron LIE-AG en el 46.56%, LIE-BG en el 22.23 % como y cervicitis crónica en el 16.27%; 12.28% de estudios fueron negativos.(au)

BACKGROUND: Cervical cancer is a public health issue, being one of the main causes of morbidity and mortality in developing countries. Cervical cytology (Papanicolaou) is performed for screening and diagnosis of cervical lesions. In case of a suspicious cytology report, colposcopy is an essential procedure for evaluation of the lower genital tract, to detect early lesions and cancer. The aim of this study was to characterize the colposcopy procedures performed, as a diagnostic and therapeutic method, in patients with abnormal Papanicolaou results. METHODS: This is an observational, descriptive cross-sectional study, whose universe were all the patients with abnormal cytological diagnosis in pap smear, who underwent a colposcopy procedure between 2015 and 2019 at Hospital José Carrasco Arteaga, with a total of 1 628 patients. RESULTS: 1 628 colposcopic procedures were included. 55.46% of the population were between 27 to 46 years of age. The predominant marital status was married status (75%). 63.45% of women had their first sexual experience between 21 and 30 years of age. 95.20% of the patients had between 1 and 3 sexual partners. Abnormal pap smear results represent; 37.28% to LSIL, followed by ASC-US (35.81%), and HSIL (14.18%). 67.32% of colposcopies were classified as satisfactory. Biopsy was performed in 71% of the patients, followed by loop electrosurgical excision procedure (LEEP) (13.69%), endocervical curettage in 11.05%. The pathology results reported HSIL in 46.56% of the cases, followed by 22.23% as LSIL and chronic cervicitis in 16.27%, 12.28% of the results were negative. CONCLUSION: Three-quarters of all colposcopies were performed on women between 27 and 56 years of age. The most frequently abnormal Pap smear results were: LSIL, followed ASC-US. 67% of the colposcopies were satisfactory. After colposcopy, biopsy was performed in most of the patients, in lower percentage: loop electrosurgical excision procedure (LEEP), endocervical curettage and diagnostic hysterectomy. Pathology results reported HSIL in 46.56%, LSIL IN 22.23% and chronic cervicitis in 16.27%; 12.28% of studies were negative.(au)

To explore the therapeutic effect of Kangfuxiaomi shuan II on cervicitis in rats

ABSTRACT Purpose: The rat cervicitis model was established with 20% phenol glue to explore the therapeutic effect of Kangfuxiaomi shuan II on rat cervicitis and its mechanism. Methods: After modeling, the rats were treated with Shuangzuotai suppository (37.84 mg/kg), Kangfuxiaoyan shuan (205.6 mg/kg) and Kangfuxiaomi shuan II (40, 80, 160 mg/kg). The histopathological changes and injury degree of cervix in rats were evaluated by vulvar inflammation score and organ index. The therapeutic effect of Kangfuxiaomi shuan II on cervicitis was evaluated by detecting the levels of copper-protein (CP), C-reactive protein (CRP), Rat interleukin 6 (IL-6), superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and epidermal growth factor (EGF), cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) in cervical tissue. Results: Compared with the model group, the vulvar inflammation score and cervical index of rats in other groups decreased significantly (P<0.01). Kangfuxiaomi shuan II could significantly reduce the levels of CP, CRP, and MDA in serum of rats with cervicitis, and significantly increase the activity of SOD in serum of rats with cervicitis (P<0.01). The levels of EGF and iNOS in cervical tissue of rats also increased in different degrees, while the level of COX-2 decreased significantly (P<0.01), which significantly improved the pathological degree of vulvar inflammation in rats with cervicitis. Conclusions: Kangfuxiaomi shuan II has a certain therapeutic effect on cervicitis in rats, and its mechanism may be related to the regulation of inflammatory cytokine network and immunity.

Brazilian protocol for sexually transmitted infections, 2020: infections that cause cervicitis

Abstract Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan cervicitis

As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.

Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.

Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan cervicitis

Resumo As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.

Abstract Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.

Resumen Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.

Prevalencia de la infección por Mycoplasma genitalium en mujeres embarazadas / Prevalence of Mycoplasma genitalium infection in pregnant women / Prevalência da infecção por Mycoplasma genitalium em gestantes

Resumen Durante los últimos 5-10 años se ha considerado a Mycoplasma genitalium como un agente emergente de infecciones de transmisión sexual. Su papel en el embarazo ha sido poco estudiado. La prevalencia en la Argentina es desconocida. El objetivo del trabajo fue determinar la prevalencia de M. genitalium en muestras endocervicales de mujeres embarazadas que concurrieron a un control ginecológico. La metodología utilizada para la detección fue una PCR de punto final que amplifica una secuencia específica del gen mgpB. Se estudiaron 270 mujeres embarazadas entre 15 y 42 años. La prevalencia global de M. genitalium fue de 5,2% (14/270). De las sintomáticas el 10% eran positivas (9/90) y de las pacientes asintomáticas 2,8% eran positivas (5/180). El 1,5% (4/270) presentó coinfección con Chlamydia trachomatis. Todas cursaban un embarazo de más de 12 semanas. Este es el primer trabajo de prevalencia de M. genitalium realizado en mujeres embarazadas en la Argentina. Se necesitan más estudios de asociación entre este microorganismo y las complicaciones en el embarazo para avanzar hacia la prevención y el control de esta infección.

Abstract Mycoplasma genitalium has been considered an emerging agent of sexually transmitted infections for the past 5-10 years. Its association with agent of non-gonococcal urethritis in men is well recognized. In women it has been linked to cervicitis, endometritis and pelvic inflammatory disease. Its role in pregnancy has been poorly studied. In Argentina, the prevalence is unknown. The objective of this work was to determine the prevalence of M. genitalium in endocervical samples of pregnant women who attended a gynecological control. An end-point PCR was used to amplify a specific sequence of the mgpB gene. A group of 270 pregnant women between 15 and 42 years were studied. The overall prevalence of M. genitalium was 5.2% (14/270). Among the symptomatic patients, 10% were positive (9/90), whereas among the asymptomatic patients, 2.8% were positive (5/180). Only 1.5% (4/270) presented co-infection with Chlamydia trachomatis. This is the first prevalence study on M. genitalium performed on pregnant women in Argentina. More studies are needed to understand the relationship between this microorganism and complications during pregnancy, in order to prevent and control this infection in women.

Resumo O Mycoplasma genitalium tem sido considerado um agente de infecções sexualmente transmissível emergente nos últimos 5 a 10 anos. Seu papel na gravidez tem sido pouco estudado. Na Argentina, a prevalência é desconhecida. O objetivo deste trabalho foi determinar a prevalência de M. genitalium em amostras endocervicais de gestantes que realizaram controle ginecológico. Uma PCR de ponto final foi utilizada como metodologia para a detecção, que amplifica uma sequência específica do gene mgpB. Um grupo de 270 gestantes entre 15 e 42 anos foi estudado. A prevalência geral de M. genitalium foi de 5,2% (14/270). Entre as pacientes sintomáticas, 10% foram positivas (9/90), ao passo que entre as assintomáticas, 2,8% foram positivas (5/180). Apenas 1,5% (4/270) apresentou coinfecção por Chlamydia trachomatis. Todas as mulheres estudadas estavam grávidas fazia mais de 12 semanas. Este é o primeiro estudo de prevalência sobre M. genitalium realizado em mulheres grávidas na Argentina. Mais estudos de associação entre esse microorganismo e as complicações na gravidez são necessários, a fim de avançar na prevenção e no controle desta infecção.

An immunohistochemistry and histopathological study of ankaferd blood stopper in a rat model of cervical inflammation

SUMMARY OBJECTIVE: Ankaferd Blood Stopper (ABS) is a medicinal plant extract used topically as a hemostatic, anti-inflammatory, and anti-oxidant agent. Its cytoprotective effect mainly depends on its pleiotropic properties by modulating inflammatory mediators such as IL-1β, IL-6, and TNF-α. This study aims to test the possible therapeutic effect of ABS in the treatment of erosive and inflammatory conditions occurring in the uterine cervix. METHODS: Twenty-four female Wistar Albino rats were used in the present study. Trichloracetic acid was applied intravaginally to establish an experimental rat model of cervicitis. The rats were randomly divided into three groups: group I (injury), group II (injury+isotoinc saline), and group III (injury+ABS). After 3 estrous cycles of ABS and isotonic saline treatment, the amount of inflammation, vascular congestion and erosion were evaluated in the cervical tissues by using a modified semi-quantitative scale of 0-3. Immunohistochemical staining with monoclonal antibodies against IL-1β was also performed. RESULTS: Compared with group I and II, the ABS group showed the least inflammatory cell infiltration, vascular congestion and cervical erosion, compared with the ABS group prominent IL-1β staining observed in group I and group II. CONCLUSION: Our data suggest that ABS is a highly effective alternative to induce normal cervical epithelium and can be used safely in the treatment of cervical inflammation with or without cervical erosion.

RESUMO OBJETIVO: Ankaferd Blood Stopper (ABS) é um extrato de plantas medicinais utilizado topicamente como um agente hemostático, anti-inflamatório e antioxidante. O seu efeito citoproteico depende principalmente das suas propriedades pleiotrópicas por meio da modulação de mediadores inflamatórios tais como IL-1β, IL-6 e TNF-a. O objetivo deste estudo é testar o possível efeito terapêutico do ABS no tratamento de condições erosivas e inflamatórias que ocorrem no colo uterino. MÉTODOS: Vinte e quatro ratas Wistar Albino foram utilizadas no presente estudo. O ácido tricloroacético foi aplicado intravaginalmente para estabelecer um modelo experimental de cervicite em ratos. Os ratos foram divididos aleatoriamente em três grupos: grupo I (lesão), grupo II (lesão + fisiológico sérico) e grupo III (lesão + ABS). Após três ciclos estrais de ABS e tratamento fisiológico sérico, as quantidades de inflamação, congestionamento vascular e erosão foram avaliadas nos tecidos cervicais usando uma escala semiquantitativa modificada de 0-3. Coloração imuno-histoquímica com anticorpos monoclonais contra IL-1β também foi realizada. RESULTADOS: Em comparação com os grupos I e II, o grupo ABS mostrou menos infiltração de células inflamatórias, congestionamento vascular e erosão cervical. Além disso, em comparação com o grupo ABS, observou-se uma coloração proeminente de IL-1β no grupo I e no grupo II. CONCLUSÃO: Nossos dados sugerem que o ABS é uma alternativa altamente eficaz para induzir o epitélio cervical normal e pode ser utilizado com segurança no tratamento da inflamação cervical com ou sem erosão cervical.

Comparação da Quantidade de Células de Langerhans em Neoplasias Intraepiteliais Cervicais e Cervicites Crônicas / Comparison of the Quantity of Langerhans Cells in Cervical Intraepithelial Neoplasia and Chronic Cervicitis / Comparación de la Cantidad de Células de Langerhans en Neoplasias Intraepiteliales Cervicales y Cervicites Crónicas

Introdução: O câncer cervical é atribuído ao papilomavírus humano (HPV) cuja infecção, na maioria das vezes, sofre regressão espontânea. A menor porção de casos que evoluem para lesão precursora de baixo e alto graus e invasora pode ter relação com uma falha na atividade das células de Langerhans em eliminar o vírus. Objetivo: Determinar se há redução do número de células de Langerhans em colos uterinos acometidos por neoplasias intraepiteliais cervicais (NIC), graus I e III, comparado ao grupo controle (cervicites crônicas), por imuno-histoquímica, possibilitando correlacionar a ação do sistema imune com o desenvolvimento dessas lesões. Método: Foram analisados 40 casos de cervicite crônica, NIC I e III, com diagnóstico anatomopatológico entre janeiro de 2014 e dezembro de 2015, buscando-se comparar a quantidade de núcleos marcados positivamente como célula de Langerhans pela proteína S-100 por imuno-histoquímica, quantificando-os em áreas padronizadas. Resultados: Dos 40 casos avaliados, 17 foram cervicite crônica, 13 NIC I e 10 NIC III. Na análise comparativa do número de células em cada grupo a média, desvio-padrão e mediana foram maiores no grupo cervicite crônica e menores no grupo NIC III. O valor de p encontrado para a variação do número de células de Langerhans, entre os grupos, foi significativo (p=0,0442); mas, ao comparar os grupos de NIC com o controle, só o grupo NIC III teve variação significativa (p=0,0209). Conclusão:Há diminuição significativa do número de núcleos de células de Langerhans marcados em lesões do tipo NIC III em comparação a cervicites crônicas.

Introduction: Cervical cancer is attributed to human papillomavirus (HPV), whose infection mostly undergoes spontaneous regression. The smaller part of cases that evolve to low and high-grade lesions or invasive lesions may be related to failure of Langerhans cell activity to eliminate the virus. Objective: To determine if there is reduction of Langerhans' cells in cervix uterus affected by cervical intraepithelial neoplasms (CIN) grades I and III compared to control group (chronic cervicitis) by immunohistochemistry, granting the correlation of the immune system action with the development of these lesions. Method: It were analyzed 40 cases of chronic cervicitis, CIN I and III with anatomopathological diagnosis between January 2014 and December 2015, attempting to compare the amount of positively labeled Langerhans cells nuclei by S-100 protein by immunohistochemistry, quantifying them in standard areas. Results: Of the 40 evaluated cases, 17 were chronic cervicitis, 13 CIN I and 10 CIN III. The comparative analysis of the number of cells in each group showed that the mean, standard deviation and median number of Langerhans cells per area were higher in the chronic cervicitis group and lower in the CIN III group. The p value found in the variation of the Langerhans cells number among the groups was significant (p=0.0442). However, when comparing the CIN groups directly with the control group, only the CIN III group had a significant variation (p=0.0209). Conclusion: There is a significant decrease in the number of marked Langerhans cell nuclei in CIN III type lesions compared to chronic cervicitis.

Introducción: El cáncer cervical puede atribuirse al virus del papiloma humano (VPH) cuya infección a menudo sufre regresión espontánea. El menor número de casos que evolucionan a lesiones precursoras de bajo y alto grado o invasivas puede estar relacionado con una falla en la actividad de las células de Langerhans para eliminar el virus. Objetivo: Determinar si hay reducción del número de células de Langerhans en colos uterinos acometidos por neoplasias intraepiteliales cervicales (NIC) grados I y III comparado al grupo control (cervicitis crónicas), por medio de inmunohistoquímica, posibilitando correlacionar la acción del sistema inmune con estas lesiones. Método: Se analizaron 40 casos de cervicitis crónica, NIC I y III, con diagnóstico anatomopatológico entre enero de 2014 y diciembre de 2015, comparando la cantidad de núcleos marcados positivamente como célula de Langerhans por la proteína S-100 por inmuno-histoquímica, cuantificándolos. Resultados: De 40 casos, 17 fueron cervicitis crónica, 13 NIC I y 10 NIC III. En el análisis comparativo del número de células en cada grupo la media, desviación estándar y mediana fueron mayores en el grupo cervicite crónica y menores en el NIC III. El valor de p encontrado para la variación del número de células de Langerhans entre los grupos fue significativo (p=0,0442), pero al comparar los grupos de NIC con el control sólo el grupo NIC III tuvo variación significativa (p=0,0209). Conclusión: Hay disminución significativa del número de núcleos marcados de células de Langerhans en lesiones de tipo CIN III en comparación con cervicitis crónica.

Prevalence of inflamatory processes in the reproductive tracts of crossbred dairy cows / Prevalência de processos inflamatórios no sistema reprodutivo de vacas leiteiras mestiças

This study evaluated the prevalence of cervicitis and endometritis and their interrelations in crossbred dairy cows that were more than 60 days in milk (DIM), and the efficiency of the cytology technique (cytobrush) and histology as diagnostic methods for these diseases. The reproductive tracts (n=149) derived from cows were collected from a slaughterhouse and grossly evaluated to determine uterine involution and the phase of the estrous cycle. Subsequently, cervical and uterine cytological evaluations were done to characterize the inflammatory response as cervicitis (with a neutrophilic count greater than 5%) or endometritis (with more than 6% neutrophils). Additionally, randomly obtained samples from the cervix and uterus were collected for histological evaluation. Cytological evaluation revealed that the frequency of cervicitis was 6% (9/149), and endometritis was diagnosed in 8.1% (12/149) of the samples; both inflammatory reactions were diagnosed 2.1% (3/149) in three of these. Histological evaluation revealed that of the cows diagnosed with cervicitis by cytology, 66.6% (6/9) had no inflammatory reaction in the cervical mucosa, and 33.3% (3/9) had mild inflammation in this region. Histological evaluation of the uterine horn revealed that of the 12 cows diagnosed with endometritis by cytology, 50% (6/12) of these had a histological diagnosis of mild and moderate inflammatory responses, 8.3% (1/12) of these demonstrated a severe inflammatory response, while no inflammatory reaction was identified in 41.7% (5/12) of the endometrial biopsies evaluated. In conclusion, the endometrial and cervical inflammatory response diagnosed by the cytobrush technique persisted in 12.1% of the cows. Comparatively, the frequency of the inflammatory responses at the cervix and uterus was reduced by histological analysis relative to cytological evaluation with the cytobrush technique.

O objetivo deste estudo foi determinar a prevalência de cervicite e endometrite citológicas e suas inter-relações em vacas leiteiras mestiças com mais de 60 dias pós-parto (DPP), bem como avaliar as técnicas de citologia (cytobrush) e histologia como métodos diagnósticos para estas doenças. Foram utilizados 149 tratos reprodutivos de vacas com mais de 60 DPP de abatedouro e avaliados macroscopicamente para determinar a involução uterina e a fase do ciclo estral. Posteriormente, realizou-se citologia cervical e uterina para o diagnóstico de inflamação utilizando como ponto de corte, contagem de polimorfonucleares (PMN) superior a 5% e 6%, respectivamente, para cervicite e endometrite citológica. Também foram coletadas amostras de cérvix e útero para histologia. Do total de vacas, identificaram-se 6% (9/149) com cervicite e 8,1% (12/149) com endometrite citológica, sendo três destes animais (2,1%) com ambas as inflamações. Histologicamente, dos animais com cervicite citológica, 66,6% (6/9) não apresentaram infiltrado inflamatório na mucosa cervical e 33,3% (3/9) apresentaram inflamação leve. A histologia uterina mostrou que de 12 vacas com endometrite citológica, 50% (6/12) apresentaram infiltrados inflamatórios leves a moderados, 8,3% (1/12) grave e 41,7% (5/12) não tinham Inflamação endometrial. Concluiu-se que a inflamação endometrial e cervical, por meio da técnica de citologia, persistiu em 12,1% das vacas com mais de 60 DPP. Quando se utiliza a histologia como método de diagnóstico, a detecção de inflamação cervical e uterina é inferior ao detectado pela técnica de citologia por meio do esfregaço endometrial (cytobrush).

Bacteriological, cytological and histopathological evaluation of the reproductive tract of slaughtered cows / Avaliação bacteriológica, citológica e histopatológica do trato reprodutivo de vacas abatidas

Reproductive diseases, mainly endometritis, are important hurdles in cattle raising, In the current study we evaluated gross, bacteriological, cytological, and histological findings from selected sites of the genital from 23 slaughtered cows and tested whether there is an association between these findings and the probability of reaching a reliable diagnosis. The results from the examinations of macroscopic aspects of uterine secretions, the cytological, bacteriological, and histopathological findings were then correlated. There was no significant correlation (P>0.05) of the statistical data from different parts of the genital tract. Trueperella pyogenes and Escherichia coli were isolated from the vagina in 3/23 cases. In only 2/23 samples Enterococcus faecalis and a gram-negative, oxidase-positive bacteria were isolated from the cervix uteri. Only Staphylococcus epidermidis, in 1/23 case, was isolated from the uterus. Histopathological findings in uterus from samples of Groups II (moderate lesions) and III (severe lesions) did not translated in grossly visible changes. Samples from reproductive tracts with secretion in the vagina and cervix uteri had no detectable changes in the other parameters analyzed from this portion. Uterus with positive bacterial culture had evidence of ascendant inflammation judging by the high granulocyte count in the three analyzed portions. This study reinforces that vaginitis and cervicitis in the cow diagnosed only by clinical examination does not reflect the real status of the uterine health. For this reason, treatment of uterine disorders should be conducted based on reliable tests to determine the appropriate therapy for each situation.(AU)

Doenças reprodutivas causam altas perdas econômicas nos rebanhos bovinos, sendo a endometrite uma das alterações mais relevantes. Os objetivos desta pesquisa foram avaliar a associação dos achados fisiopatológicos em exames macroscópicos, bacteriológicos, citológicos e histopatológicos nas porções do trato genital de 23 vacas abatidas, bem como avaliar a necessidade de associação destes exames para efetuar diagnóstico fidedigno. A avaliação macroscópica da secreção, os exames histopatológico, citológico e as bactérias identificadas foram correlacionados. Não houve associação (P>0,05) dos resultados nas diferentes porções do trato genital. Na vagina foram isoladas as bactérias Trueperella pyogenes e Escherichia coli. Na cérvix, em apenas 2/23 (8,6%) amostras isolou-se Enterococcus faecalis e gram negativo oxidase positiva. No útero houve isolamento apenas da bactéria Staphylococcus epidermidis. As amostras histopatológicas classificadas em grupo II e III não apresentaram alterações detectadas no exame macroscópico. As amostras com secreção não fisiológica na vagina e cérvix não apresentaram alterações nos outros exames na porção uterina. A amostra com cultura bacteriológica positiva no útero demonstrou uma infecção ascendente através da alta contagem de granulócitos nas três porções analisadas. O presente estudo reforça o conceito de que a vaginite e cervicite diagnosticadas pelo exame clinico na vaca não retratam o real status da saúde uterina e por esta razão, o tratamento do útero deve ser conduzido com critério, alicerçado nos exames complementares para definir a terapia adequada para cada situação.(AU)

Asociación de infección por Chlamydia trachomatis con el diagnóstico de cervicitis aguda / Association of Clamydia trachomatis with the Diagnosis of Acute Cervicitis

Las infecciones de transmisión sexual se consideran un problema de salud pública en el mundo debido a su creciente incidencia y elevada morbimortalidad (1). Las infecciones por Chlamydia trachomatis son las más comunes y costosas de las enfermedades de transmisión sexual bacterianas (2). En los estudios llevados a cabo en diferentes países se han encontrado prevalencias de C. trachomatis entre 1.7% y 25%, siendo más alta en la población menor de 25 años (1). La infección por clamidia genital causa cervicitis y salpingitis en mujeres, y uretritis y conjuntivitis tanto en hombres como en mujeres. Sin embargo, las infecciones por clamidia suelen producir pocos o ningún síntoma (en aproximadamente el 70% de las mujeres y el 50% de los hombres) y pueden permanecer sin ser detectadas y sin tratamiento. Si no se trata, esta infección de transmisión sexual puede progresar y causar complicaciones con graves consecuencias sobre la salud reproductiva de las mujeres, incluida la enfermedad inflamatoria pélvica (EPI) que puede conducir al embarazo ectópico y a la infertilidad de las trompas (3)...(AU)

Is cryotherapy friend or foe for symptomatic cervical ectopy?

Objective: To evaluate the success rates and clinical outcomes of cervical cryotherapy applied to cervical ectopy for symptomatic relief

Subjects and Methods: A total of 124 women who underwent cryotherapy for symptomatic treatment of cervical ectopy were included in this study. Indications for treatment were: abundant leucorrhoea [n = 114], post-coital bleeding [n = 22], recurrent cervicitis [n = 30] and pelvic pain [n = 12]. Cryotherapy consisted of the use of carbon dioxide at -89[degree]C to destroy the ectopic columnar epithelium by freezing, and it was transmitted to the ectopy through a flat cryoprobe. No routine anaesthesia or analgesia was administered. All patients were questioned about the status of their symptoms after 6 weeks of treatment

Results: The highest success rate was obtained in patients with abundant leucorrhoea [n = 102; 89.5%], while the lowest success rate was achieved in subjects with pelvic pain [n = 7; 58%]. After treatment, no severe complications were observed, except for hydrorrhoea for a few days. Success rates were 9 times lower in patients who had 3 or more cervicitis episodes per 6 months

Conclusion: In this study, the success rate of cryotherapy was highest in patients with abundant leucorrhoea and lowest in patients with pelvic pain and recurrent cervicitis. Hence, we recommend that clinicians perform the procedure in such patients without much delay

Asociación de infección por Chlamydia trachomatis con el diagnóstico de cervicitis aguda / Associação da infecção de Chlamydia trachomatis com o diagnóstico de cervicite aguda / Association of Chlamydia trachomatis with the Diagnosis of Acute Cervicitis

La infección por Chlamydia trachomatis es la enfermedad de transmisión sexual mßs frecuente en el mundo y causa una importante morbilidad en las mujeres. Actualmente existen pocos estudios sobre su prevalencia en nuestra población, por lo que se hace pertinente la implementación de un estudio piloto que aporte información sobre su frecuencia en mujeres asintomßticas y con cervicitis aguda. Objetivo: determinar la asociación existente entra la infección por Chlamydia trachomatis y la presencia de cervicitis aguda en la población consultante a los servicios de urgencias y consulta externa del Hospital Universitario de Santander (HUS). Metodología: estudio de casos y controles en el cual se incluyeron 284 pacientes mayores de edad, no embarazadas y que no estuvieran menstruando, atendidas en el HUS. Se tomaron como casos las pacientes con diagnóstico de cervicitis aguda y controles aquellas sin el mismo. En los dos grupos se realizó un frotis endocervical al cual se aplicó un método de diagnóstico rßpido para infección por Chlamydia trachomatis, Bioline Chlamydia SD®...

Chlamydia trachomatis infection is the most frequent sexually transmitted disease in the world causing heightened morbidity in women. Currently there are few studies about its prevalence in our population; therefore, the implementation of a pilot study about its frequency in women with and without acute cervicitis is necessary. Objective: Determine the association between Chlamydia trachomatis infection and the diagnosis of acute cervicitis in the consulting women in both the outpatient and inpatient services of the Hospital Universitario de Santander (HUS). Method: Case control study including 284 patients of adult age, non-pregnant and without menses who consulted HUS. Cases with acute cervicitis diagnosis and routine control ones were considered for the purpose of this study. Endocervical samples and a quick diagnostic method for Chlamydia trachomatis, Bioline Chlamydia SD were applied. Results: Mean age was 32.08 and 28.82 years for cases and controls, mean difference was 3.27, p = 0.001. There were also differences in the evaluation of marital status; 82.40% controls have a marital relationship versus 71.83% cases, p = 0.014; occupation, more students in the cervicitis group, p = 0.020; and alcohol consumption, 21.13% in cervicitis patients versus 11.27% in the control group, p = 0.024. Chlamydia prevalence was 7.04% in controls and 11.97% in cases, p = 0.157. There was no association between acute cervicitis and Chlamydia infection, OR = 1.79 (IC 95% 0.74 û 4.55). This lack of association persists after adjusting for confusing factors (OR = 1.71, IC 95% 0.72 û 4.04). In the multivariate analysis only alcohol consumption is associated with acute cervicitis, OR = 4.442 (IC 95% 1.362 û 14.215)...

A infecção por Chlamydia trachomatis é a doença sexualmente transmissível mais comum no mundo, causando significativa morbidade nas mulheres. Atualmente, existem poucos estudos sobre sua prevalência nossa população, por isso torna-se relevante a implementação de um estudo piloto para fornecer informações sobre a sua frequência em mulheres assintomßticas com cervicite aguda. Objetivo: Determinar a associação entre a infecção por Chlamydia trachomatis e a presença da cervicite aguda nas pessoas que frecuentam e consultam no pronto socorro e o ambulatorio do Hospital Universitßrio de Santander (HUS). Metodologia: No estudo dos casos e nos controles de 284 pacientes foram incluídas mulheres idosas, não grßvidas e as que não estavam no periodo menstrual atendidas pelo HUS. Para o estudo dos casos foram selecionadas aquelas com o diagnóstico de cervicite aguda e para o control as que não tinham a doença. Em ambos grupos é realizado um esfregaço endocervical para ao qual é aplicado um método de diagnóstico rßpido para Chlamydia trachomatis, Chlamydia SD ® Bioline. Resultados: A idade média foi de 32.08 e 28.82 para casos e controles, com uma diferença média de 3.27, p = 0.001. Houve também diferenças na avaliação de estado civil; 82.40% dos controles têm um vínculo conjugal contra 71.83% dos casos, p = 0.014; ocupação, mais alunos no grupo que, em casos cervicite, p = 0.020; e consumo de ßlcool, 21.13% dos pacientes com cervicite, contra 11.27% dos controlos, p = 0.024. A prevalência da infecção por Chlamydia nos controlos era 7.04% e 11.97% nos casos, p = 0.157. O estudo revelou que não ha uma associação entre cervicite aguda e infecção por Chlamydia, OR = 1.79 (IC 95% 0.74-4.55). Esta falta de associação permanece após o ajuste dos potenciais fatores de confusão (OR = 1.71, CI 0.72 95% - 4.04). Na anßlise multivariada só o ßlcool permanece associado com a presença de cervicite, OR = (IC 95% 1.362-14.215) 4.442...

Costo-efectividad del diagnóstico etiológico de la cervicitis por c. trachomatis basado en pruebas rápidas comparado con el abordaje sindrómico, en mujeres no gestantes con síntomas de infección del tracto genital inferior / Cost-effectiveness of etiologic diagnosis for C. trachomatis infection based on rapid tests versus syndromic approach in non-pregnant women with symptoms of lower genital tract infection

Objetivo: estimar la razón costo-efectividad del diagnóstico etiológico con pruebas rápidas para la cervicitis por C. trachomatis frente al diagnóstico sindrómico, en mujeres no gestantes con síntomas de infección del tracto genital inferior en Colombia. Materiales y métodos: se construyó un árbol de decisión para determinar la razón de costo-efectividad de la aproximación etiológica con las pruebas rápidas Acon®Plate, Acon®Duo y QuickVue® para la detección de C. trachomatis comparada con el diagnóstico sindrómico. La perspectiva fue la del sistema de salud colombiano incluyendo todos los costos médicos directos. El horizonte de tiempo fue de 15 días, ya que la unidad de resultado fue el número de casos correctamente identificados (número de verdaderos positivos y verdaderos negativos). Las características operativas de las pruebas se obtuvieron en un estudio de corte transversal diseñado y conducido para este propósito. Resultados: la alternativa más costosa y más efectiva fue QuickVue® seguida de Acon®Plate y del abordaje sindrómico. Acon®Duo fue una estrategia dominada. La razón de costo-efectividad incremental de QuickVue®, comparada con Acon®Plate, fue de $ 430.671; la de Acon®Plate, comparada con el abordaje sindrómico, fue de $ 79.747. Conclusión: si la disponibilidad a pagar (DAP) por un caso correctamente identificado adicional es mayor que $ 430.671, QuickVue® sería la mejor alternativa en términos de costo-efectividad; de otro lado, si la DAP está entre $ 79.747 y $ 430.671, Acon®Plate sería la alternativa costo-efectiva. Finalmente, si la DAP es menor que $ 79.747, el abordaje sindrómico sería la mejor alternativa en términos de costo-efectividad.

Objective: To estimate the cost-effectiveness of etiological approach with rapid tests for C. trachomatis cervicitis versus syndromic diagnosis, in non-pregnant women with symptoms of lower genital tract infection in Colombia. Materials and methods: A decision tree was developed for determining the cost-effectiveness ratio of the aetiological approach using the Acon®Plate, Acon®Duo and QuickVue® quick tests for the detection of C. trachomatis, compared with the syndromic diagnosis. The perspective was that of the Colombian healthcare system, including medical direct costs. The time period was 15 days, considering that the outcome unit was the number of cases identified correctly (number of true positives and true negatives). The operational characteristics of the tests were derived from a cross-sectional study designed and conducted for that specific purpose. Results: The more costly and effective option was QuickVue®, followed by Acon®Plate and the syndromic approach. Acon®Duo was a dominated strategy. The incremental cost-effectiveness ratio for QuickVue® compared with Acon®Plate was $430.671, and that of Acon®Plate compared with the syndromic approach was $79.747. Conclusion: If the willingness to pay (WTP) for an additional case that is correctly identified is greater than $430.671, QuickVue® would be the best option in cost-effectiveness terms. On the other hand, if the WTP is between $79.747 and $430.671, Acon®Plate would be the cost-effective strategy. Finally, if the WTP is less than $79.747, the syndromic approach would be the best option in cost-effectiveness terms.

Progressive loss of E-cadherin immunoexpression during cervical carcinogenesis

PURPOSE: To investigate E-cadherin immunoexpression during cervical carcinogenesis. METHODS: We assessed the immunohistochemical expression of E-cadherin in squamous intraepithelial lesions (SIL - 52 cases), squamous cell carcinoma (SCC) of the uterine cervix (23 cases) and also in eight cases of cervicitis. RESULTS: The results show very different E-cadherin membrane expression levels when cervicitis (88%), SILs (73%) and SCC (17%) were compared. In SILs, higher E-cadherin loss was seen in less differentiated cells in the basal third of the epithelium. This study suggests that the absence of E-cadherin expression in the membrane is a molecular event that is observed more often in SCC of the uterine cervix than in SILs or cervicitis. CONCLUSIONS: E-cadherin is an essential molecule during the process of cervical carcinogenesis and in this context exhibits a different expression pattern according to the epithelial thickness layer. .

Histeroscopia de consultorio: evaluación del dolor / Office hysteroscopy: pain assessment

Objetivo: Evaluar el dolor durante la histeroscopia de consultorio, sin anestesia e investigar los factores relacionados. Métodos: Estudio prospectivo, descriptivo, analítico y de corte transversal en una población de 309 pacientes de la Maternidad “Concepción Palacios” que acudieron al Servicio de Ginecología entre agosto 2010 y agosto 2011, quienes tenían indicación para histeroscopia. Se registraron antecedentes y datos clínicos relacionados con la percepción del dolor, así como la intensidad de dolor percibida mediante una escala análoga de 0 al 10. Resultados: Se obtuvo una media de percepción de dolor de 2,9. La percepción de dolor fue leve en 56.%, dolor moderado: 36,2 %, dolor intenso: 4,9 %, dolor intolerable: 2,9 %, nada de dolor: 4,2 %. No se encontró relación entre la percepción de dolor y la edad, paridad, estado hormonal, indicación del estudio ni tipo de procedimiento. El 60,6 % de las pacientes con cuello permeable, presentaron dolor leve, mientras que las que tenían sinequias o estenosis lo presentaron en 25,5 % y 31, 3 % respectivamente. Con cuello permeable hubo 0,4 % de dolor intolerable y en presencia de sinequias la cifra fue 12,5 % (P<0,05). 88,8.% de las pacientes con dolor intolerable presentaban estenosis o sinequias. Conclusiones: La histeroscopia de consultorio es un procedimiento bien tolerado por la mayoría de las pacientes; es independiente de la paridad, condición hormonal, indicación del estudio, edad y tipo de procedimiento. La percepción de dolor fue mayor en pacientes con estenosis o sinequias cervicales.

Objective: Assess pain during no anesthesia office hysteroscopy and investigate related factors. Method: Prospective, descriptive, analytical and cross-section study in a population of 309 patients who attended the gynaecology service of Maternidad Concepción Palacios between August 2010 and August 2011, who had indication for hysteroscopy. Background and clinical data was collected, relating to the perception of pain, as well as the intensity of pain perceived by means of an analog scale of 0 to 10. Results: An average of 2.9 pain perception. The perception of pain was mild in 56 %, moderate pain: 36.2 %, severe pain: 4.9 %, intolerable pain: 2.9 %, none of pain: 4.2 per cent. No relationship was found between the perception of pain and age, parity, hormonal state, indication of the study or type of procedure. 60.6 % of patients with permeable cervix presented mild pain, while if they had adhesions or stenosis the mild pain was present in 25.5 % and 31, 3 % respectively. With permeable cervix there was 0.4 % of intolerable pain and in the presence of adhesions was only 12.5 % (P < 0,05), 88.8 % of patients with intolerable pain had cervical stenosis or adhesions. Conclusions: Office hysteroscopy is a procedure well tolerated by most patients; It is independent of parity, hormonal condition, indication of the study, age and type of procedure. The perception of pain was greater in patients with cervical stenosis or adhesions.

Cytological versus serological diagnosis of Herpes Simplex Virus type 2 infection among women with cervicitis without external genital ulcer or blistering lesions in Hawler Maternity Teaching Hospital

Herpes simplex virus type 2 linked to the genital tract infection may produce significant acute or chronic cervicitis. Identification of the virus is important due to its association with genital tract disease and sexual transmission. The virus establishes lifelong latency with periodic reactivation. Therefore, it causes significant physical and psychological morbidity. The aim of this study was to assess and compare cytological examination with serological test in the diagnosis of genital herpes simplex virus type 2. This study included 104 women. Pap smear was collected from 24 healthy women as a control group [group A], 40 patients with severe cervicitis on cytological examination [group B] and 40 patients with atypical cervicitis [group C]. Blood sample was obtained from the patients and the control group and tested for Herpes simplex virus type 2 specific serology. The ages of the studied groups ranged from 21-53 years. They were referred to the Maternity Teaching Hospital and private laboratories in Erbil city, Kurdistan region, Iraq during the period from December 2011 to December 2012. Herpes simplex virus type 2 IgG antibodies were found in 10 sera from patients with nonspecific cervicitis [group-B] and only in three patients with atypical cervicitis [group-C]. No positive serological test was identified in the control group. All Pap smear results showed features suggestive of cervicitis but without viral cytopathic herpetic changes. The serological test was superior to cytology for the diagnosis of Herpes simplex virus type 2 infection in women presented with cervicitis with no clinically apparent genital ulcer or blisters