Assessment of Correlation Between Clinical And Pathological Diagnoses In Oro - Maxillary Biopsies (A retrospective 6 year-study)

Clinical diagnosis of oral lesions is a difficult task. Correlation between clinical and microscopic diagnosis demonstrates correct viewpoint between clinician and pathologist.Nowadays use of radiography, biopsy and microscopic survey are auxiliary ways for definite diagnosis of lesions. The purpose of this study was to evaluate the correlation between clinical and microscopic diagnosis of oral lesions in patients referred to oral pathology department of Islamic Azad Dentistry University of Tehran from 2005 to 2009. This descriptive study was done based on existing data. Variants of study including age& sex of patient, location of lesion (central, peripheral), clinical diagnosis (1st diagnosis) and microscopic diagnosis & clinician's degree (general- specialist) was recorded. Statistical analysis was done with SPSS13 using concordance coefficient and statistic model "binary logistic regression". Out of 1337 cases 238 cases were without clinical diagnosis (21%). Agreement in clinical µscopic diagnosis was found in 683 cases (concordance coefficient %65/1). Concordance coefficients were %52/1 in first clinical diagnosis. The greatest concordance coefficient was observed in diagnosis of epulis fissuratum, pemphigus vulgaris, papilloma, ranula. Non specific ulcer, benign epithelial hyperplasia, leukoplakia, myxoma and Keratoacanthoma revealed the lowest coefficient. Sex age, referral clinician, location of lesion & type of lesions did not have significant effect on concordance coefficient. The highest concordance coefficient was obtained from oral and maxillofacial surgeons. Absence of a clinical diagnosis in a lot of the cases demonstrates that clinicians neglect the value of clinical data on the definite diagnosis.