A Retrospective Analysis of Concordance Between Clinical and Histopathologic Diagnoses and Completeness of Oral Biopsy Forms at a Tertiary Dental Hospital in Eastern Nepal.

Abstract

Introduction: Histopathological diagnosis remains the gold standard tool for the diagnosis, yet accurate and detailed clinical descriptions are necessary to facilitate the final diagnosis. Histopathologists believe that clinicians are unaware of how histopathology departments operate, partly because of the less information on requisition forms. The objective of the present study is to assess the concordance of clinical and histological diagnoses of all oral and maxillofacial biopsy samples, along with the completion of the requisition form provided with the biopsy sample. Methods: A retrospective study was conducted at the Department of Oral Pathology. The biopsy request forms of year 2018-2019 were retrieved from the archive of the department and were analyzed for clinicopathological concordance. Descriptive and analytical statistics were performed using SPSS. Results: Of 338 forms, 243 (71.89%) forms had total concordance between clinical and histopathologic diagnosis; 20 forms (5.92%) had concordance with the histopathological diagnosis, but only after the clinical diagnosis had been refined. Of all the forms analyzed, 36 (10.65%) forms lack habit history in cases suspected of oral cancer and oral potentially malignant disorder, and 24 (7.10%) cases lack radiographic details. The categories of clinicohistopathological concordance and the different clinical information groups showed a statistically significant relationship. We also found that the sign-out time for histopathological reports depend on the extent of clinical information provided which was statistically significant too. Conclusions: The current study concluded a sufficient level of concordance between clinical and histopathological diagnosis. A high completion rate of biopsy forms indicated that the clinicians/operating surgeons perceive the significance of clinical information in histopathological diagnosis. We also recommend, irrespective of the type of suspected oral lesions, submitted for biopsy, a detailed clinical information is the backbone for accurate and timely reporting of the histopathological diagnosis.