Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

Abstract

The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability.

Concordancia del diagnóstico clínico y el diagnóstico histopatológico de lesiones en tejidos blandos de cavidad oral.

“…Un mayor porcentaje de concordancia entre el diagnóstico clínico con el histológico (81%) fue determinado en el estudio de Benyahya y cols., donde analizaron 21 biopsias (8). Curra y cols., examinaron las muestras de tejido blando, específicamente, en labio, del período de 1946 al 2011, con el fin de corroborar el diagnóstico clínico de éstas al clasificarlas benignas, premalignas y malignas de acuerdo con el diagnóstico histopatológico, obteniendo una sensibilidad de 88.3%, una especificidad de 98.2% y una exactitud de 97.4% (14); estos porcentajes son altos, posiblemente por limitar el estudio a la estructura de los labios. En el estudio de Vale y cols., al evaluar las características clínico-patológicas de lesiones en niños y adolescentes, se encontró que hubo un 61.5% de concordancia entre ambos diagnósticos (2).…”