Integrated morphologic and molecular analysis of Trichomonas vaginalis, Mycoplasma hominis, and human papillomavirus using cytologic smear preparations

Abstract

Pathogenic microbes may colonize the female genital tract via sexual transmission and cause health issues like inflammation or malignancy, summarized as sexually transmitted disease (STD). A major representative of such pathogens is Trichomonas vaginalis (T.v.), whose role in the etiology of cervical cancer remains elusive. Traditional morphologic screening of cervical smears is able to detect T.v., although its identification may be complicated by look-alikes such as degenerated granulocytes and basal cells. In addition, the parasite's endosymbiont Mycoplasma hominis (M.h.) cannot be detected in the Pap test. This investigation was aimed at designing a PCR-based method to detect specific pathogenic germs by using cervical cytology slides to overcome morphologic uncertainty and increase diagnostic accuracy. To test our molecular screening method on T.v., M.h., and HPV in archival smears, we elaborated a multiplex PCR approach based on microdissection. This assay was applied to a minute quantity of starting material which harbored or was suspected to harbor T.v.; the resulting isolated DNA was used for subsequent molecular analyses of T.v., M.h., and HPV. We clarified the diagnosis of genital T.v. infection in 88 and 1.8% of morphologically suspicious and T.v.-negative cases, respectively. We also revealed a tendency of M.h. co-infection in high-risk HPV cases. In conclusion, a microdissection-based approach to detect pathogenic microbes such as T.v., HPV, and M.h. is a molecular tool easy to implement and may help to better understand the interactivity of these germs with respect to pathogenesis.

Association between asymptomatic sexually transmitted infections and high-risk human papillomavirus in cervical lesions

“…Different screening strategies for women in different stages are good for earlier diagnosis of disease and cost saving for medical resources. In our study, only MH showed a significant positive association with hrHPV, as previously described, 21,22 although these previous studies could not rule out reverse causation. We did not find that MH infection was related to cervical carcinogenesis.…”

Biomarkers expression among paired serous ovarian cancer primary lesions and their peritoneal cavity metastases in treatment‐naïve patients: A single‐center study

“…39 Although we used only FFPE blocks-derived from HGSOC primary histology samples and peritoneal metastases processed as CBs-and identical IHC protocols to minimize technical variations and make our findings comparable, specimen handling could still differ in any step of this study or during the previous routine diagnostic preparation (e.g., duration of fixation), potentially impacting our results. Although cytology generally provides excellent material for IHC and molecular testing, 8,40 CB cytology samples in this study showed lower tumor cellularity than their paired histology, albeit both exhibiting adequate numbers of cancer cells for analysis (at least 100 cancer cells in all examined cases were needed as an inclusion criterion). This could have affected the subsequent IHC interpretation.…”

Prevalence of Trichomonas Infection in Relation to Human Papillomavirus (HPV) in Pap Smear Samples of Female Patients Referred to Shahid Sadoughi Hospital, Yazd (Iran)

“…Studies have shown that a previous history of infection with TV leads to an increased risk of HPV infection, which is mainly due to the types of viruses with a high oncogenic risk [ 19 , 20 ]. It was also shown that HPV is a risk factor for TV, indicating a possible cooperation between these microorganisms that contributes to changes in the cellular microenvironment [ 21 ]. The TV, through the release of lytic enzymes, leads to the reduction of the mucous layer of the vaginal wall and, thus, the reduction of vaginal fluids.…”