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Acta Cytol. 2008 Jul-Aug;52(4):439-44.

Performance of 3 methods for quality control for gynecologic cytology diagnoses.

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1
Pathology Division, Adolfo Lutz Institute, Department of Pathology, Federal University of São Paulo, Sã Paulo, Brazil.

Abstract

OBJECTIVE:

To evaluate performance and viability of internal quality control (QC) strategies in a public health laboratory of the state of São Paulo.

STUDY DESIGN:

A retrospective study was performed with 3 QC strategies to improve internal cytologic diagnoses: morphologic guided-list criteria (MGLC), 100% rapid-rescreening (100% RR) of negative slides ("turret" method) and 10% rescreening (10% R) of negative slides. Cases were examined at Adolfo Lutz Institute, São Paulo, Brazil, from 2002 to 2004. Histopathologic results, when available, were considered gold standard; cytologic consensus diagnosis was by 2 pathologists when histologic results were unavailable.

RESULTS:

MGLC selected 20.7% samples with cytologic atypias, 10% R selected 0.6% and RR selected 2.5%. Cytologic/histologic initial concordance was 57.4%, low-grade squamous intra-epithelial lesion false negative rate was 34.9% and high-grade squamous intraepithelial lesion false negative rate was 12.2%. After diagnosis, consensus concordance was 97.2%.

CONCLUSION:

The 100% RR and 10% R QC strategies detected more false negative cases in liquid-based cytology than in conventional Pap smears. The 100% RR strategy reduced the false negative results and allowed evaluation of individual staff performance. The 10% R strategy did not offer significant results. We concluded that association of MGLC and 100% RR strategies might improve cytologic diagnostic quality.

PMID:
18702361
DOI:
10.1159/000325549
[Indexed for MEDLINE]
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