Onofre M A, Sposto M R, Navarro C M, Motta M E, Turatti E, Almeida R T
Department of Diagnosis and Surgery, School of Dentistry of Araraquara, UNESP, Brazil.
Oral Dis. 1997 Sep;3(3):148-52. doi: 10.1111/j.1601-0825.1997.tb00026.x.
To evaluate the discrepancy index between the clinical and histological diagnosis and the prevalence of epithelial dysplasia and carcinoma in 45 patients with potentially malignant epithelial oral lesions (PMEL).
We submitted 45 patients with PMEL to clinical examination and obtained a biopsy from each. The results of histological diagnosis were compared to the clinical diagnosis.
Clinical diagnosis showed that the most common PMEL was leukoplakia followed by lichen planus and by actinic cheilitis associated with leukoplakia. The most common site was the buccal mucosa. Histological diagnosis revealed that 46.7% of the PMEL were lichen planus. The discrepancy index between clinical and histological diagnosis was 24.4%. The higher discrepancy index occurred among leukoplakias. The prevalence of epithelial dysplasia and carcinoma was 17.8%.
We conclude that all PMEL should be submitted to a microscopic analysis because the discrepancy between clinical and histological diagnosis was present in a quarter of these lesions. Otherwise, the epithelial dysplasia and carcinoma were more frequent in the leukoplakias.
评估45例口腔潜在恶性上皮性病变（PMEL）患者的临床诊断与组织学诊断之间的差异指数以及上皮发育异常和癌的患病率。
我们对45例PMEL患者进行了临床检查，并对每例患者进行活检。将组织学诊断结果与临床诊断结果进行比较。
临床诊断显示，最常见的PMEL是白斑，其次是扁平苔藓以及与白斑相关的光化性唇炎。最常见的部位是颊黏膜。组织学诊断显示，46.7%的PMEL为扁平苔藓。临床诊断与组织学诊断之间的差异指数为24.4%。白斑中的差异指数更高。上皮发育异常和癌的患病率为17.8%。
我们得出结论，所有PMEL均应进行显微镜分析，因为这些病变中有四分之一存在临床诊断与组织学诊断之间的差异。此外，上皮发育异常和癌在白斑中更为常见。
