Controle da qualidade em citopatologia cervical: revisão da literatura
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Data
2007
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Resumo
Cervical cytopathology is an important tool for the detection of precursor lesions of cervical cancer, which are still
treatable at that stage, thus resulting in a significant decrease in mortality. However, cervical cytopathology has
drawbacks, with the false-negative rate varying from 2 to 50%. False-negative results are mainly due to errors in
sample collection, examination, and interpretation. The ultimate objective of routine internal and external quality
control in laboratories is to improve the test's diagnostic performance, evaluate screener performance, and identify
causes of sample collection errors. Internal quality control can be performed regularly and involves monitoring the
sample adequacy, duration of the examination, screener workload, hierarchical review of smears, and review of
negative smears. Internal quality control can also include analysis of the cytology/histology correlation, review of
previous exams, monitoring of statistics on frequency of lesions and sample adequacy, and deliberate inclusion of
abnormal smears in routine exams. Continuing education, personnel training, and periodic proficiency exams are
strategies that should be adopted. Random or 100% review of smears, rapid review, and detailed reviews are
methods that have advantages and disadvantages for the detection of false-negative results. It is the laboratory's task
to define the best strategy for internal quality control that will lead to improvement in technical procedures and
consequently in the quality of the service provided by cytopathology laboratories.
Descrição
Palavras-chave
Câncer cervical, Teste de papanicolaou, Controle de qualidade, Sensibilidade, Falso-negativos, Erro de escrutínio, Cervical cancer, Pap smear, Quality control, Screening error, Sensitivity, False-negative results
Citação
TAVARES, Suelene Brito do Nascimento et al. Controle da qualidade em citopatologia cervical: revisão da literatura. Revista Brasileira de Cancerologia, Rio de Janeiro, v. 53, n. 3, p. 355-364, 2007.