The Diagnostic Accuracy of Incisional Biopsy in the Oral Cavity.

Purpose: To determine the accuracy of incisional biopsy examination to diagnose oral lesions.Materials and Methods: This retrospective cohort study was performed to determine the concordance rate between incisional biopsy examination and definitive resection diagnosis for different oral lesions. The...

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Publicado en:Journal of Oral & Maxillofacial Surgery (02782391) Vol. 74; no. 5; pp. 959 - 965
Autores principales: Chen, Sara, Forman, Michael, Sadow, Peter M., August, Meredith
Formato: research Journal Article
Publicado: W B Saunders May2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2016
      vid: 74
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        atl: The Diagnostic Accuracy of Incisional Biopsy in the Oral Cavity.
      aug:
        au:
          Chen, Sara
          Forman, Michael
          Sadow, Peter M.
          August, Meredith
        affil: Resident PGY1, Department of Restorative Dentistry (Prosthodontics), University of Illinois at Chicago, Chicago, IL; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
      sug:
        subj:
          Biopsy Methods
          Mouth Diseases Diagnosis
          Mouth Pathology
          Adult
          Mouth Mucosa Pathology
          Retrospective Design
          Salivary Gland Diseases Pathology
          Mouth Diseases Pathology
          Child
          Salivary Gland Diseases Diagnosis
          Mouth Neoplasms Pathology
          Aged
          Female
          Aged, 80 and Over
          Male
          Mouth Surgery
          Young Adult
          Middle Age
          Adolescence
          Mouth Neoplasms Diagnosis
          Salivary Glands Pathology
          Human
          Adult: 19-44 years
          Child: 6-12 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Adolescent: 13-18 years
          Female
          Male
      ab: Purpose: To determine the accuracy of incisional biopsy examination to diagnose oral lesions.Materials and Methods: This retrospective cohort study was performed to determine the concordance rate between incisional biopsy examination and definitive resection diagnosis for different oral lesions. The study sample was derived from the population of patients who presented to the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital (Boston, MA) from January 2005 through December 2012. Inclusion criteria were the diagnosis of an oral lesion from an incisional biopsy examination, subsequent diagnosis from the definitive resection of the same lesion, and complete clinical and pathologic patient records. The predictor variables were the origin and size of the lesion. The primary outcome variable was concordance between the provisional incisional biopsy diagnosis and definitive pathologic resection diagnosis. The secondary outcome variable was type of biopsy error for the discordant cases. Incisional biopsy errors were assessed and grouped into 5 categories: 1) sampling error; 2) insufficient tissue for diagnosis; 3) presence of inflammation making diagnosis difficult; 4) artifact; and 5) pathologist discordance.Results: A total of 272 patients met the inclusion criteria. The study sample had a mean age of 47.4 years and 55.7% were women. Of these cases, 242 (88.9%) were concordant when comparing the biopsy and final resection pathology reports. At histologic evaluation, 60.0% of discordant findings were attributed to sampling error, 23.3% to pathologist discrepancy, 13.3% to insufficient tissue provided in the biopsy specimen, and 3.4% to inflammation obscuring diagnosis. Overall, concordant cases had a larger average biopsy volume (1.53 cm(3)) than discordant cases (0.42 cm(3)).Conclusion: The data collected indicate an 88.9% diagnostic concordance with final pathologic results for incisional oral biopsy diagnoses. Sixty percent of discordance was attributed to sampling error when sampled tissue was not representative of the lesion in toto. Multiple-site biopsy specimens and larger-volume samples allowed for a more accurate diagnosis.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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