Papanicolaou smears from 100 woman with ELISA Chlamydia-positive (42) and negative (58) endocervical smears were examined. Chlamydial endocellular inclusions were found in 3 ELISA positive and 2 negative smears, with an evident low sensitivity (7%) of cytology in the diagnosis of the endocervical infection. Furthermore, by statistical analysis it is clear that a negative test doesn't add anything to the pre-test probability (prevalence) of the infection. On the other hand a positive pap-smear adds a poor information, if compared with immunoenzimathic assay and IF staining. Thus, the Papanicolaou smear can't be considered of diagnostic value for Chlamydial infection. Furthermore, it proves unsuitable even for screening programs on high-risk patients, concerning which the immunoenzymatic assay appears, as previously affirmed, the most suitable effort.
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