Jornal Brasileiro de Patologia e Medicina Laboratorial
versión impresa ISSN 1676-2444
BONILHA, Jane Lopes et al. Cervical cytology quality control: rapid pre-screening with marked field. J. Bras. Patol. Med. Lab. [online]. 2006, vol.42, n.6, pp. 441-448. ISSN 1676-2444. http://dx.doi.org/10.1590/S1676-24442006000600007.
INTRODUCTION: The Pathology and Forensic Medicine Department of the Faculdade de Medicina de São José do Rio Preto, SP had decided to develop a Quality Control System following the NBR ISO 9001: 2000 guidelines. Some procedures were adopted to verify technical reliability for the exams performed, where quality is defined as the clients' judgement, i.e., the solution for the clients' requests and expectations. In this study we have focused on the quality of the cervical cytology performed in the Department. Although the development of cervical lesions through cervical carcinoma takes place slowly, the treatment will have a better chance of success in case of an early diagnosis. Considering all the possible diagnostic mistakes, the false-negative exam is the most dangerous, as it delays the beginning of the treatment. OBJECTIVE: To test three different methods looking for the one with the smaller number of false-negative results. MATERIAL AND METHODS: For the same team of technicians, and with the same diagnostic criteria the three different techniques were tested. Methodology 1 (M1): in accordance to the Brazilian Ministry of National Health, with a random review of 10% of the false-negative results, in the 3,500 cytologies; Methodology 2 (M2): rapid review (RR), as suggested in literature, consists of a rapid review of 100% of the smears, after their routine evaluation, and was done in 7,373 cytologies; Methodology 3 (M3): rapid prescreening (RP) with marked field, was proposed by the researcher and consists of a rapid screening of all cases, pointing out a field were there are abnormal cells, and after that the normal screening, in 8,096 cytologies. RESULTS: The three techniques tested showed the following false-negative rates: M1: 2.4%; M2: 1.7% and M3: 1.2 %. CONCLUSION: The M3 was the best methodology, presenting less false-negative diagnosis.
Palabras llave : Rapid pre-screening; Cervical cytology; Quality control.