Todos os sistemas de avaliação de desempenho em laboratórios de citopatologia exigem um programa de controle interno da qualidade estabelecido e executado. O presente estudo tem por objetivo identificar os resultados do programa e o desempenho dos citotécnicos. Para tanto foram revistos os laudos, emitidos pelos citotécnicos e pelos citopatologistas, de 48.355 exames citopatológicos ginecológicos realizados durante 21 meses. Foram identificados 2.299 casos anômalos encaminhados ao citopatologista, e confirmados 1.132; 2.973 casos de alto risco foram detectados e 998 anômalos identificados. A revisão de 10% dos negativos representou 3.180 casos, com identificação de 77 anômalos. Os anômalos totais detectados foram: 1.176 Ascus, 60 Agus, 819 Nic I/HPV, 85 Nic II, 33 Nic III, 11 carcinomas escamosos, 17 adenocarcinomas, cinco Vain I e um Vain III. Os Ascus/Agus foram 56%, e as outras lesões representaram 44%. Os 4,56% de anômalos detectados concordam com os valores propostos por Cardin (3% a 5%), pelo sistema Bethesda (4% a 6%) e por Kurman et al. (5%) (4, 6, 7). O citopatologista revisou 17,48% dos casos (n = 8.452). Dos 77 (0,16% do total) anômalos identificados no reescrutínio, 59 (0,12%) foram Ascus, seis (0,01%) Agus e 12 (0,02%) Nic I. O presente estudo mostra resultados do controle interno da qualidade desenvolvido em laboratório particular e fornece dados relevantes para o planejamento de um programa de prevenção do câncer uterocervical.
Any system which mesures the performance of Cytopathology Laboratories demands an established Internal Quality Control Program. The objective of this research is to identify the data of the Program and the performance of the cytotechnologists. We have reviewed 48,355 gynecologic cytopathology reports from cytotechnologists and cytopathologists for 21 months. We have identified 2,299 abnormal cases submitted the cytopathologist of which 1,132 were confirmed; 2,973 cases classified as high-risk were informed and 998 abnormal cases were identified. The revision of 10% of the negative cytologies represented 3,180 cases, of which 77 abnormal reports were identified. These encompassed 1,176 Ascus, 60 Agus, 819 Nic I/HPV, 85 Nic II, 33 Nic III, 11 squamous cell carcinomas, 17 adenocarcinomas, 5 Vain I and 1 Vain III. The Ascus/Agus were 56% of the cases and 44% corresponded to the other lesions. The 4.56% of abnormal cases were in accordance to the values proposed by Cardin (3-5%), the Bethesda System (4-6%) and Kurman et al. (5%) (4, 6, 7). The cytopathologists reviewed 17.48% of the cases (n = 8,452). Of the 77 abnormal cases (0.16% of the total) which were identified in the re-screening, 59 (0.12%) were Ascus, 6 (0.01%) were Agus and 12 (0.02%) were Nic I. This research shows the results of the Internal Quality Assurance developed in a private laboratory and give relevant information for planning a uterocervical cancer prevention program.