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Variability among studies evaluating vaginal polymorphonuclears counts

Studies performed so far abound with such methodological differences which do not permit either comparison across the studies or drawing firm conclusions. Among the differences, two issues stand out in particular. First, the surface on which reference values for normal and pathological numbers of PMN were determined has commonly been defined as a high power field (HPF, x1000). Unfortunately, actual surfaces of HPF can differ 2-3 times depending on the technical characteristics of a microscope. Second, the observed surface is very small compared to the entire surface of the sample – often only 5-10 HPF out of a potential 15,000 to 30,000 fields of view (FOV). These are, in our opinion, the most important reasons for such divergent values for normal and pathological numbers of PMN ranging from 1 PMN per HPF4 up to 32 PMN per HPF. In some studies, cut-off values for normal and pathologic PMN counts are the same at different magnifications!? However, the technical characteristics of a microscope will not impact results if PMN numbers are expressed in PMN/EC ratio

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Dane Nenadic

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