■诊断口腔颌面部病变是一个多步骤,多学科过程。如果临床诊断是可以实现的,然后进行组织病理学诊断以支持和确认诊断。因此,组织活检的组织病理学检查是诊断和/或治疗计划的重要组成部分。目的探讨口腔颌面部病变的临床及组织病理学诊断与患者的一致性,病变,以及可能影响本协议的医疗保健提供者因素。
■这是一个观察,对吉达阿卜杜勒阿齐兹国王大学牙科学院口腔病理学中心实验室和大学牙科医院的所有患者进行的横断面研究,沙特阿拉伯,2018年至2022年用于诊断口腔颌面部病变。提取的数据包括有关转诊牙科提供者的信息,例如他们的临床经验(年数),专业,认证,和教育。评估了临床和组织病理学诊断之间的一致性,和logistic回归用于评估与诊断准确性相关的提供者特征.
■在44.1%(n=378)的病例中,临床和病理诊断是一致的,牙源性肿瘤的一致性最高(72.7%,n=24),显着高于炎性病变(37.3%,n=111)。诊断准确率最高的解剖位置是舌腹面(71.4%,n=5),其次是嘴唇(52.6%,n=20)。患者年龄和性别以及牙医的经验年限与诊断一致性无关(分别为p=0.2,p=0.9和p=0.08)。然而,一致的诊断与牙医的等级(p=0.02)和专业(p=0.01)显著相关。与其他专业控制教育时的病理诊断相比,口腔外科医生在活检时进行的临床诊断与病理诊断一致的可能性是1.6倍(p=0.01),认证,和多年的经验。
■这些数据提醒我们,仅靠临床诊断不足以确保最终诊断和计划治疗。组织病理学检查对于大多数口腔和颌面部病变仍然是必不可少的。
UNASSIGNED: Diagnosing oral and maxillofacial lesions is a multi-step, multidisciplinary process. If a clinical diagnosis is achievable, then a histopathological diagnosis is indicated to support and confirm the diagnosis. Histopathological examination of tissue biopsies is therefore an essential part of the diagnosis and/or treatment plan. The purpose of this study was to investigate the agreement between the clinical and histopathological diagnoses of oral and maxillofacial lesions and the patient, lesion, and healthcare provider factors that may affect this agreement.
UNASSIGNED: This was an observational, cross-sectional study of all patients who had been referred to the Oral Pathology Central Laboratory at the Faculty of Dentistry and University Dental Hospital at King Abdulaziz University in Jeddah, Saudi Arabia, between 2018 and 2022 for diagnosis of oral and maxillofacial lesions. Data extracted included information about the referring dental provider such as their clinical experience (number of years), specialty, certification, and education. Agreement between the clinical and histopathological diagnoses was evaluated, and logistic regression was used to assess provider characteristics associated with the accuracy of diagnosis.
UNASSIGNED: The clinical and pathological diagnoses were concordant in 44.1% (n=378) of cases, and concordance was highest for odontogenic tumors (72.7%, n=24), significantly higher than for inflammatory lesions (37.3%, n=111). The anatomical locations with the highest diagnostic accuracy were the ventral surface of the tongue (71.4%, n=5), followed by the lips (52.6%, n=20). Patient age and sex and the dentist\'s years of experience were not associated with diagnostic agreement (p=0.2, p=0.9, and p=0.08, respectively). However, concordant diagnoses were significantly associated with the dentist\'s rank (p=0.02) and specialty (p=0.01). Clinical diagnoses made by oral surgeons at the time of biopsy were 1.6-times more likely (p=0.01) to agree with the pathological diagnosis compared with those made by other specialties when controlling for education, certification, and years of experience.
UNASSIGNED: These data are a reminder that a clinical diagnosis alone is not sufficient to secure the final diagnosis and to plan treatment. Histopathological examination remains essential for most oral and maxillofacial lesions.