The Accuracy of Clinical Diagnosis in Biopsied Premalignant and Malignant Oral Lesions.

Objectives: Due to the importance of clinical impression in accurate final diagnosis of oral pathologic lesions, this study evaluated the agreement rate between clinical and histopathological diagnosis in of oral premalignant (PML) and malignant lesions, over a period of 22 years.

Materials and methods: In this retrospective and cross-sectional study, 861 cases were reviewed. Patients' clinical data, type of biopsy, clinical appearance of the lesion, as well as clinical impression and histopathological diagnosis were noted using the archived medical files. Descriptive statistics and Chi-square test were used for analyzing the data.

Results: Overall, the agreement rate between histopathological and clinical diagnoses was 71.9%. This rate was 71.8% in PML and 75.7% in malignant lesions. The highest agreement among all lesions was found in OLP, in the mouth floor and by oral medicine specialists.

Conclusion: The results showed a relatively high agreement rate between clinical and histopathologic diagnosis of PML and malignant lesions. Clinical presentation, site and type of biopsy, as well as clinicians' specialty were associated with this rate. More education, careful clinical examination, and more cooperation between the surgeon and pathologist are necessary for accurate diagnosis and management.