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PURPOSE: To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. METHODS: The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. RESULTS: Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. CONCLUSION: An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills ...
OBJETIVOS: Verificar o impacto da educação continuada realizada pelo Laboratório de Monitoramento Externo da Qualidade nos indicadores de monitoramento interno da qualidade dos exames citopatológicos. MÉTODOS: O estudo avaliou os indicadores de monitoramento interno da qualidade dos exames citopatológicos de 12 laboratórios monitorados pelo Laboratório de Monitoramento Externo da Qualidade, totalizando 185.194 exames, sendo 98.133 referentes ao período antes da educação continuada e 87.061 após a educação continuada. Os dados para avaliar os indicadores foram obtidos por meio do Sistema de Informações do Câncer do Colo do Útero disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. RESULTADOS: Verificou-se que, após a educação continuada, quatro laboratórios mantiveram o índice de positividade (IP) dentro do recomendado, quatro que estavam abaixo passaram a ter o IP dentro do recomendado, um permaneceu baixo, dois permaneceram muito baixo e um passou de muito baixo para baixo. Em relação ao indicador percentual de exames compatíveis com lesão intraepitelial escamosa de alto grau, cinco laboratórios mantiveram o índice dentro do recomendado, três que estavam abaixo do recomendado passaram a ter esse índice acima de 0,4 e quatro permaneceram abaixo do recomendado. Os indicadores atipias de significado indeterminado/alterados e razão atipias de significado indeterminado/lesões intraepiteliais mantiveram-se dentro do recomendado em todos os laboratórios. CONCLUSÃO: Observou-se melhora nos indicadores de positividade e percentual de exames compatíveis com lesão intraepitelial de alto grau, mostrando que o papel desempenhado pelo Laboratório de Monitoramento Externo da Qualidade contribui para o aprimoramento ...
Subject(s)
Female , Humans , Cervix Uteri/pathology , Clinical Laboratory Services/standards , Clinical Laboratory Techniques/standards , Quality Indicators, Health Care , Brazil , Pathology, Clinical/education , Quality ControlABSTRACT
Objective To investigate the β-tubulin Ⅲexpression in locally advanced cervical cancers and its significance in the neoadjuvant chemotherapy of cervical cancer .Methods Immunohistochemistry was used to detect the expression of β-tubulin Ⅲin tissue samples from 62 cases of locally advanced cervical cancer patients .Groups paclitaxel +cisplatin/carboplatin (TP) (34 pa-tients) underwent two cycles of TP chemotherapy ,while group 5-fluorouracil+cisplatin(PF) (28 patients) underwent two cycles of PF chemotherapy .Comprehensive analysis of β-tubulinⅢexpressions of TP and PF neoadjuvant chemotherapies revealed the efficien -cy and operation rate .Results The positive rate ofβ-tubulin Ⅲ was 62.90% in locally advanced cervical cancer .β-tubulin Ⅲ ex-pression was not correlated with clinicopathological features in locally advanced cervical cancer ( P >0.05 ) .β-tubulinⅢexpression was correlated with efficiency and operation rate with TP chemotherapy but not with PF chemotherapy .Conclusions In the neoadju-vant chemotherapy of locally advanced cervical cancers ,β-tubulinⅢexpression can be used as an important index to predict the effec-tive rate of combined chemotherapy containing paclitaxel and guide the patients to individual chemotherapy .
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Objective To investigate the correlation between the characteristics of the computed tomography (CT) perfusion parameters and the expression of D2-40 with lymphatic vessel density (LVD) in cervical carcinomas.Methods A total of 42 patients with cervical carcinoma was divided into two groups with and without lymph node metastasis.Patients were evaluated with CT perfusion scan before operation.Monoclonal antibody D2-40 was used for immunohistochemistry to detect the LVD in the carcinoma tissue specimen.CT perfusion parameters and LVD of two groups were compared,and their relationship was analyzed.Results CT perfusion parameters including blood flow (BF),peak enhancement image (PEI),and blood volume (BV) in the lymph node metastasis group were significantly higher than those in the no lymph node metastasis group (t =-2.206,-2.29,-2.336,P ＜ 0.05).The time to peak (TTP) was significantly lower in the lymph node metastasis group than the no node metastasis group (t =6.908,P ＜ 0.01).The LVD in the lymph node metastasis group was significantly higher than the no lymph node metastasis group (t =-5.092,P ＜ 0.01).The CT perfusion parameters (BF,PEI,BV) and LVD of cervical carcinomas had a significantly positive correlation (r =0.65,0.56,0.61,P ＜ 0.01).The TTP and LVD had a significantly negative correlation(r =-0.55,P ＜ 0.01).Conclusions CT perfusion imaging and higher LVD help to diagnose the lymph node metastasis of a cervical carcinoma,and have important guidance role in the surgical options for cervical cancers.
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Objective To observe the inhibitory effect of andrographolide (AD) on the migration and invasion of human cervical cancer cells,and investigate the molecular mechanisms underlying the inhibitory effect of AD.Methods Human cervical cancer cell lines HeLa cells were cultured in vitro.After induced by 100 nmol/L of phorbol-12-myristate-13-acetate(PMA) for 24 h,different concentration of AD was co-incubated for another 24 h.Cell viability was detected by methyl thiazolyl tetrazoliym (MTT) assay.Chamber invasion assay was used to observe the migration and invasion,respectively.Expression of matrix metalloproteinase-9 (MMP-9) and translocation of nuclear factor kappa B (NF-κB) p65 subunit were detected by Western blot.Results The concentration (0 ～ 10 μmol/L) of AD exhibited a non-cytotoxic effect on HeLa cells.10 μmol/L of AD decreased PMA-induced migration by 49％ and invasion by 52％.Western blot showed that AD suppressed PMA-induced MMP-9 protein expression in a dose-dependent manner.Treatment of AD could decrease the translation of p65 in HeLa cells.Conclusions AD inhibits MMP-9 expression mediated by NF-κB,which lead to the suppression of migration and invasion of cervical cancer cells.