Análise da concordância entre diagnósticos clínicos e histopatológicos de lesões orais.

Abstract

Oral lesions diagnosis makes important part of the dentistry practice once directs the therapeutic and/or preventive approaches of clinicians. However, it is very common there are discrepancies between the clinical and microscopic diagnoses of lesions influencing the prognosis of patients. Aims: Present study evaluated the agreement between clinical and microscopic diagnoses of oral lesions from a public oral histopathology service hosted in a region of the Paraíba State, Brazil. Methods: It was performed a transversal, observational and analytic study through data collection from 483 medical records of patients, being descriptively and inferentially analyzed in an attempt to define the percentage of correct diagnosis and the concordance level by mean of the Kappa test, permitting to evaluate their possible associations to sociodemographic and clinicopathological variables, with p value ≤0.05. Results: Total percentage of accuracy between clinical and microscopic diagnoses was 57,9% and the diagnostic concordance was interpreted as regular (K=0,426), the groups of odontogenic tumors (K=0,622) and the one formed by microscopic diagnoses of normal tissues and nonspecific inflammatory processes (K = 0.136) presented higher and lower accuracy, respectively. Oral leukoplakia/epithelial dysplasia obtained superior indexed of agreement (K=0,714) while the fibrous hyperplasia (K=0,382) reached poor levels. The diagnostic concordance was influenced by the group lesions classification (p<0,001), by the pathology nature (p<0,001), by the anatomic site (p=0,002) and by the location in intra- or extraosseous (p=0,025). Conclusions: Most of the clinical diagnostic hypotheses were in agreement, the level of agreement was considered to be regular, reinforcing the need for continuing education in oral diagnosis by professionals.