Analysis of Discrepancy Index between Clinical and Histopathological Diagnosis of Oral Lesions

Document Type : Research Articles


1 Oral Pathology Department, Foundation University College of Dentistry, Islamabad, Pakistan.

2 Oral Surgery Department, Foundation University College of Dentistry, Islamabad, Pakistan.

3 Oral Medicine, Riphah International University, Islamabad, Pakistan.

4 Oral Pathology Department, Riphah International University, Islamabad, Pakistan.


Objective: To analyze the discrepancy index between the clinical and histological diagnosis of oral lesions. Materials and method: A sample of 910 cases from year 2013-2021 were analyzed using non probability convenience sampling technique. This included patient records and histopathological reports of patients treated at IIDC & H and FUCD & H. Clinical presentations were classified under five categories; growth/swelling, vesico-ulcerative, white, red/pigmented, and cystic lesions. To evaluate the details of diagnostic discrepancies, the data was categorized into 4 major groups: 1) Neoplastic-Neoplastic,2) Non-Neoplastic-Non-Neoplastic ,3) Neoplastic-Non-Neoplastic and 4) Non-Neoplastic-Neoplastic. The association between clinical diagnosis and histopathological diagnosis was calculated by using pearson chi square test and statistical significance was considered with the p value less than (0.05). Results: Most common clinical presentation was swelling/growth; 601 (66%), followed by ulceration; 223 (24.5%). There were 528 (58%) incisional and 382 (42%) excisional biopsies. The definitive diagnosis based on histopathological findings showed malignant neoplasms as the commonest category; 287 (31.5%) followed by inflammatory/reactive lesions 271 (29.8%). A consensus was noted between the clinical and histologic diagnosis in 74.8% cases, while a discrepancy index of 25.1 % was calculated. Regarding diagnostic discrepancy among four major categories of our research, maximum discrepancy was noted in neoplastic-nonneoplastic category (29.6%) and minimum discrepancy was noted in malignant – benign category (2.7%).  Statistically significant difference between the clinical and histopathological diagnosis was observed with a p value of 0.000. Conclusion: Considerable amount of diagnostic discordance was observed in all types of pathologies analyzed in the study.


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