Monitoramento externo da qualidade dos laudos citopatológicos cérvico-vaginais emitidos por laboratórios do estado do Rio Grande do Norte

Abstract

External Quality Monitoring (MEQ, in portuguese) comprises a set of actions carried out by a reference laboratory (Type II) that aim to evaluate the quality of cytopathological exams from other Laboratories (Type I), from the pre-analytical phase to the results of the diagnostic reports. This work aims to evaluate the quality of cervical-vaginal cytopathological reports issued by Type I laboratories affiliated with the Unified Health System in the Rio Grande do Norte. It describes the precision and sensitivity of the cytological reports evaluated, points out the aspects more discrepant changes in the reports released by Type I laboratories when compared to those released by the Type II Laboratory and reports the impact that reports modified by the Type II Laboratory, which were previously released by the different Type I Laboratories, have on the treatment of patients. 1962 cytopathological slides were selected and analyzed from 11 Type I Laboratories. The results show that 215 samples (10.95%) had their reports modified by the Type II Laboratory, in the representation of epithelia, 90 of the 215 reports modified (41.86%), as well as in the classification of lesions, among the 215 modifications observed , 93 of them (43.26%). Therefore, aspects of improvement were highlighted to make the analysis carried out more efficient. The most discrepant aspects between the analyzes of the Type I and Type II Laboratories were the representation of the epithelia and the classification of the lesions, which drastically influence the final result, potentially leading to inappropriate clinical conduct, overtreatment or undertreatment.