Agreement between clinical and histopathologic diagnoses and completeness of oral biopsy forms

Abstract

The present study aimed to assess the rate of agreement between clinical and histopathological diagnoses and to report the frequency of completed forms for specimens that were subjected to histopathological examination and retrospectively examined. Data from 8,168 specimens submitted to histopathological examination were retrieved from the records. A total of 5,368 cases were included. Agreement was defined based on the definition of lesion nature according to its diagnostic category. Sensitivity, specificity, and positive and negative predictive values were calculated for each diagnostic category. The highest rate of agreement was observed for periapical lesions (92.6%), followed by potentially malignant disorders (90.1%) and non-neoplastic proliferative disorders (89.3%). Low rates of histopathological confirmation of the clinical impression were observed for mesenchymal tumors (25.0%) and cysts (44.2%). Sensitivity values were > 0.70 for all lesions, except for cysts (0.51). Specificity was relatively high, ranging from 0.97 to 1.00. The frequency of incomplete biopsy forms ranged from 16.8% (malignant tumors of oral mucosal epithelium) to 51.0% (nonspecific inflammatory reaction). The most frequently completed biopsy forms corresponded to epithelial malignant tumors (83.2%) and glandular inflammation (72.3%). In conclusion, there was an acceptable level of agreement. The low level of completeness of biopsy forms indicates little awareness about the relevance of gathering detailed information during clinical examination.

Diagnóstico histopatológico de lesiones orales de la mesorregión agreste del estado de Pernambuco

“…O conhecimento, por parte dos dentistas, das principais manifestações de lesões orais, pode contribuir para um diagnóstico precoce de doenças graves, melhorando assim, o prognóstico do paciente (9,23). No presente estudo, a maioria dos casos teve coerência na hipótese diagnóstica quando comparada ao diagnóstico histológico, corroborando os achados outros autores (11,24).…”

Agreement Between Clinical-Radiographic and Histopathological Diagnoses in Maxillofacial Fibro-Osseous Lesions

“…When comparing the assertiveness indexes of clinical and histopathological diagnosis, in most studies FOLs are not mentioned [23,29]. The agreement between clinical and histopathological diagnoses of bone lesions observed by Mendez et al [23] were 75%. Souza et al [20] suggest FOLs are the pathologies of lesser coincidence of comparative results between clinical and histopathological diagnosis.…”

“…Diagnosis and treatment of FOLs are controversial in view of the histological similarities between them. Grouping those pathologies is not appropriate because of the different pathophysiologies [5,23]. Hence, this study aimed to compare the agreement of clinical and radiographic diagnosis with the histopathological diagnosis in FOLs of the jaws, an approach that even today is still little discussed and of relevant importance in the study of diseases affecting the maxillofacial region.…”

Oral soft tissue biopsy surgery: Current principles and key tissue stabilization techniques

“…Marked disagreement between clinical impression and histopathological report was found mainly in the mesenchymal tumors (25%) and cysts (44.2%). 18 A study conducted in the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA from January 2005 to December 2012 has found a 11.1% (30 cases) discordant diagnosis rate between the initial incisional biopsy diagnosis and final definitive resection diagnosis for various oral lesions. 19 The major reasons for discordant diagnosis are sampling error (60%), pathologists' discrepancy (23.3%), insufficient tissue of biopsy (13.3%), and inflammation-obscuring diagnosis (3.4%).…”