这项研究的目的是回顾内布拉斯加州大学医学中心(UNMC)口腔活检服务中临床医生识别白斑的诊断准确性和用于指示白斑病变的诊断术语。回顾了UNMC牙科学院1983年,1995年,2005年和2015年的活检档案。临床诊断为白斑(或白色斑块)的病例,角化过度,发育不良,和/或癌被纳入研究。记录人口统计学和临床信息,并利用描述性统计数据。在6113个案例中,508例患者中的517个病变(8.46%)符合纳入标准。患者的平均年龄为56.87岁,样本包括286名男性和222名女性。在这517个病变中,195例(37.72%)临床诊断为白斑或白色斑块。记录显示,195例临床诊断中有133例(68.21%)是正确的,组织学上表现为角化过度的病变(75例),发育不良(52例),或癌(6例)。其余62个病变(31.79%)被发现有其他组织学诊断。角化过度症占正确诊断的最大部分。总的来说,多年来,临床医生成功识别白斑的能力有所提高(46.15%,73.68%,64.29%,1983年、1995年、2005年和2015年分别为76.00%)。然而,临床医生继续错误分类可识别的病变,如扁平苔藓,苔藓样黏膜炎,纤维瘤是白斑.角化过度和发育不良,两者都代表组织学诊断,似乎被普遍误用的临床术语。
The objective of this
study was to review the diagnostic accuracy of clinicians identifying leukoplakia and the diagnostic terminology used to indicate leukoplakic lesions at the University of Nebraska Medical Center (UNMC) oral biopsy service. Biopsy archives from the years 1983, 1995, 2005, and 2015 in the UNMC College of Dentistry were reviewed. Cases with a clinical diagnosis of leukoplakia (or white plaque),
hyperkeratosis, dysplasia, and/or carcinoma were included in the
study. Demographic and clinical information was recorded and descriptive statistics were utilized. Of 6113 cases, 517 lesions (8.46%) from 508 patients met the inclusion criteria. The mean age of the patients was 56.87 years, and the sample included 286 men and 222 women. Of these 517 lesions, 195 (37.72%) were clinically diagnosed as leukoplakia or white plaque. The records revealed that 133 (68.21%) of 195 clinical diagnoses were correct, with lesions histologically exhibiting hyperkeratosis (75 cases), dysplasia (52 cases), or carcinoma (6 cases). The remaining 62 lesions (31.79%) were found to have other histologic diagnoses.
Hyperkeratosis made up the largest portion of the correct diagnoses. In general, the ability of clinicians to successfully identify leukoplakia improved over the years (46.15%, 73.68%, 64.29%, and 76.00% in 1983, 1995, 2005, and 2015, respectively). However, clinicians continue to misclassify identifiable pathoses such as lichen planus, lichenoid mucositis, and fibroma as leukoplakia.
Hyperkeratosis and dysplasia, both of which represent histologic diagnoses, appear to be popularly misused clinical terms.