Strategies Used to Improve the Quality of Citopathological Examinations

Abstract

Introduction: The cytopathological examination is used for early detection of cervical cancer precursor lesions. Objective: Evaluate the quality indicators according to the Quality Management Manual for the Cytopathology Laboratory. Method: The results of the request forms of cytopathological examinations of the Clinical Laboratory of the Pontifical University of Goiás (LC-PUC-Goiás) were verified between January 2013 and December 2017. Results: Of 6,809 diagnoses in total, 99.4% (6,768/6,809) were satisfactory, 91.3% (6,215/6,809) were negative, 8.1% (553/6,809) presented cytological abnormalities and 0.6% (41/6,809) were unsatisfactory. The Positivity Index from 2013 to 2017 was 10.5%, 7.9%, 8.6%, 6.8% and 5.3%, respectively. The percentage of examinations with high-grade intraepithelial lesion (HSIL) among satisfactory examinations in 2013 was 1.3%, in 2014, 1.0%, in 2015, 0.5%, in 2016, 0.6 % and in 2017, 0.7%, results within the established ≥ 0.4%. The atypical squamous cells (ASC)/satisfactory ratio showed values above the standard figures in 2013 with 6.8% and 2015 with 6.1%. According to the Quality Control Management Manual, it is expected that, at the most, 4% to 5% of all exams be classified as ASC. Values above 5% demand differentiated attention. Conclusion: It is of the utmost importance the continued education of professionals who participate in all stages of the process, from the preanalytical to the analytical phase, so that possible errors can be avoided and preventive measures taken for better quality interpretation of the cytopathological examinations.