Tecnicas Whole, Turret e Step no rastreamento do cancer cervical

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Objective: To compare Whole, Turret and Step cytological techniques for 100% rapid rescreening to evaluate its performance to detect false negative cases. We also tested RR performance among cytologists specifically trained for RR and for cytologists without training for RR. Methods: This is a descriptive study and diagnostic test validation. We analyze three rapid rescrening techniques: 1) Whole: The observer read the slide in horizontal sense 2) Turret: The observer runs the slide in horizontal and vertical (Greek bar) sense alternatively. 3) Step: The observer runs the slide in a stair fashion. All the observers evaluated the first 1,000 consecutive smears from women examined from 2002 February to September 2003 at Cytology Laboratory of State University of Campinas (UNICAMP) from the ongoing INCO-DEV Programme (Project # ICA4-CT-2001-10013). The slides were revised by part of two different staffs, three reviewers from UNICAMP Cytology Laboratory (CAISM), designated in this study as Lab A, and three reviewers from Division of Pathology of Adolfo Lutz Institute (IAL), designated as Lab B. The reviewers from Lab A were trained for rapid rescreening during three months before the study (one month for each technique: Whole, Turret and Step); the members of Lab B were not formerly trained, but they received a brief explanation of rapid rescreening and the three techniques. All reviewers revised 1,000 cases distributed in 3 sets of 333, 333 e 334 slides each one. The slides were changed among the three reviewers and were examined blindly. The final result was reached by consensus meeting of two senior cytopathologits and was considered the gold standard parameter for statistical purpose. Results: The final diagnostic was classified in 34 ASC-US, 1 ASC-H, 11 LSIL, 8 HSIL, 4 AGC e 11 was unsatisfactory .The sensitivity rates of the former group were: Whole 47%, Turret 47% and Step 51%, and for the second group were 39%, 32% e 47%, respectively. Conclusion: The RR techniques are more useful if used by cytologist specifically trained for RR. Among RR-trained cytologists we did not observed significant differences between the three RR-techniques. But for not RR-trained cytologists Step technique presented the best sensitivity

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