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活检前恶性和恶性口腔病变临床诊断的准确性。

The Accuracy of Clinical Diagnosis in Biopsied Premalignant and Malignant Oral Lesions.

作者信息

Khaksar Rojin, Ranjbar Mohammad-Ali, Jaafari-Ashkavandi Zohreh

机构信息

Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Maxillofac Oral Surg. 2025 Feb;24(1):52-58. doi: 10.1007/s12663-022-01779-2. Epub 2022 Aug 27.

Abstract

OBJECTIVES

Due to the importance of clinical impression in accurate final diagnosis of oral pathologic lesions, this study evaluated the agreement rate between clinical and histopathological diagnosis in of oral premalignant (PML) and malignant lesions, over a period of 22 years.

MATERIALS AND METHODS

In this retrospective and cross-sectional study, 861 cases were reviewed. Patients' clinical data, type of biopsy, clinical appearance of the lesion, as well as clinical impression and histopathological diagnosis were noted using the archived medical files. Descriptive statistics and Chi-square test were used for analyzing the data.

RESULTS

Overall, the agreement rate between histopathological and clinical diagnoses was 71.9%. This rate was 71.8% in PML and 75.7% in malignant lesions. The highest agreement among all lesions was found in OLP, in the mouth floor and by oral medicine specialists.

CONCLUSION

The results showed a relatively high agreement rate between clinical and histopathologic diagnosis of PML and malignant lesions. Clinical presentation, site and type of biopsy, as well as clinicians' specialty were associated with this rate. More education, careful clinical examination, and more cooperation between the surgeon and pathologist are necessary for accurate diagnosis and management.

摘要

目的

鉴于临床印象在口腔病理病变准确最终诊断中的重要性,本研究评估了22年间口腔癌前病变(PML)和恶性病变的临床诊断与组织病理学诊断之间的符合率。

材料与方法

在这项回顾性横断面研究中,对861例病例进行了回顾。使用存档的医疗文件记录患者的临床数据、活检类型、病变的临床表现以及临床印象和组织病理学诊断。采用描述性统计和卡方检验分析数据。

结果

总体而言,组织病理学诊断与临床诊断之间的符合率为71.9%。PML的符合率为71.8%,恶性病变的符合率为75.7%。在所有病变中,口腔扁平苔藓、口底病变以及口腔内科专家诊断的符合率最高。

结论

结果显示,PML和恶性病变的临床诊断与组织病理学诊断之间的符合率相对较高。临床表现、活检部位和类型以及临床医生的专业与该符合率相关。为了准确诊断和管理,需要更多的教育、仔细的临床检查以及外科医生和病理学家之间更多的合作。

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