Avaliação crítica das nomenclaturas diagnósticas dos exames citopatológicos cervicais utilizadas no Sistema Único de Saúde (SUS)

Abstract

PURPOSE: to identify the nomenclature for reporting cervical cytological diagnoses used by laboratories which render services to the Brazilian Unified Health System (SUS) and which participate in External Quality Monitoring (MEQ). To evaluate the information acquired from gynecologists of the SUS regarding the various diagnostic classifications that they receive in the cervical cytology diagnostic reports. METHODS: we evaluated 94 cytology reports issued by laboratories which participate in the MEQ in the State of São Paulo, Brazil, and 126 questionnaires applied to gynecologists who work for the SUS. RESULTS: out of the 94 laboratories, 81 (86.2%) use one diagnostic classification: 79 (97.6%) use the Brazilian Nomenclature for Cytological Reports (NBLC), 1 (1.2%) uses the Papanicolaou classification and 1 (1.2%) uses the Richart diagnostic classification. Of the 13 (13.8%) laboratories that use more than one classification, 5 use 2 types and 8 use 3 to 4 types, with 9 including the Papanicolau diagnostic classification. The study showed that 52 (55.3%) laboratories presented more than one descriptive diagnosis in the same report. Out of the 126 gynecologists who filled out a questionnaire evaluating the cytopathology reports, 78 (61.9 %) stated that they received laboratory reports with only one diagnostic classification, 48 (38.1%) received reports with more than one classification and 2 received reports with all 4 classifications. Among the 93 (73.8%) gynecologists who prefer only one classification, 56 (60.2%) claimed that the NBLC contributes to clinical practice, 13 (14.0%) opted for the Richart classification,

Perfil de exames citopatológicos realizados pelo Centro de Saúde da Mulher de Piripiri, Piauí do período de outubro de 2018 a outubro de 2019

“…Essa nomenclatura considera um fenômeno único, progressivo e contínuo, caracterizado por diversos graus de atipias celulares que compreendem toda a espessura do epitélio cervical ou parte dela. NIC I, NIC II e NIC III correspondem, respectivamente, a displasia leve, moderada e displasia severa/carcinoma in situ (Aguiar et al 2011).…”

A Hierarchical Feature-Based Methodology to Perform Cervical Cancer Classification

“…To standardize the terminologies, in 1988, the "Bethesda System" was developed and approved by the National Cancer Institute in the USA; the system underwent reviews in 1991, 2001, and 2014. With this new nomenclature system, the current terms for the classification of abnormal squamous cells are ASC-US, LSIL, ASC-H, HSIL, SC [33,34].…”

Projeto Extensionista: uma Abordagem Interdisciplinar junto à Enfermagem na Prevenção do Câncer do Colo Uterino

“…Na busca pela excelência na qualidade dos exames de Papanicolaou, em 2002, o Ministério da Saúde aprova a Nomenclatura Brasileira para Laudo dos Exames Citopatológicos, que adaptou o Sistema Bethesda ao Brasil. Uniformiza-se assim o uso da nomenclatura no Brasil, com introdução de novos conceitos estruturais e morfológicos contribuindo para o desempenho do laboratório e na relação entre citologia e a clínica (BRASIL, 2012a;AGUIAR, et al, 2011). Assim a amostra é classificada em satisfatória e insatisfatória, além de critérios de rejeição.…”