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Estudo retrospetivo da concordância entre o diagnóstico clínico e anatomopatológico em pacientes da clínica universitária Egas Moniz
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Advisor(s)
Abstract(s)
Introdução: As lesões que ocorrem na cavidade oral podem ser um desafio de diagnóstico para o Médico Dentista. O diagnóstico histológico (anatomopatológico) ou
por meios complementares de imunohistoquímica podem ser mandatários e muitas vezes apresentam-se como capazes de fornecer um diagnóstico definitivo.
Objetivos: Avaliar a concordância entre o diagnóstico clínico e anatomopatológico de
lesões orais em pacientes sujeitos a biópsias na Clínica Universitária Egas Moniz.
Identificar as lesões orais mais frequentes e a sua correlação com idade, género e
localização anatómica.
Materiais e Métodos: Análise retrospetiva de 368 processos, referentes a 350 indivíduos
do sexo masculino e feminino, com idades compreendidas entre 10 e 87 anos de idade.
Foram analisados dados das Histórias Clínicas recolhidos entre 2008 e 2018 de indivíduos submetidos a uma ou mais biópsias realizadas na Clínica Universitária Egas Moniz. Fez-se o registo da localização da lesão, diagnóstico clínico, anatomopatológico, os hábitos tabágicos e etílicos. Os diagnósticos histológicos registados foram posteriormente agrupados por grupos de patologia.
Resultados: O género mais afetado foi o feminino, representando 55% da amostra. O
estrato etário mais afetado situou-se nos 61-70 anos e o menos afetado nos 10-20 anos. A localização anatómica mais biopsada foi a gengiva (23,9%). Entre os grupos mais
prevalentes, encontram-se as lesões do tecido conjuntivo (32,1%), os quistos dos
maxilares (15,8%) e as Lesões Brancas (15,5%). As cinco entidades patológicas mais
frequentes foram o Fibroma, o Quisto Radicular, o Líquen Plano Oral, o Hemangioma e
a Leucoplasia. Avaliando a concordância, verifica-se que 74,5% de casos concordantes e 25,5% discordantes.
Conclusão: A população em estudo foi afetada por 35 entidades histológicas diferentes,
o que comprova a importância da realização de estudos de prevalência de lesões com
expressão oral e alerta a importância do papel do médico dentista de forma a prevenir e
tratar as doenças orais.
Introduction: Lesions that occur in the oral cavity can be a challenge for the dentist. Histological (pathological) diagnosis or by complementary means of immunohistochemistry may be mandatory and often shown to enable definitive diagnosis. Objectives: To evaluate the agreement between the clinical and histopathologic diagnosis of oral lesions in patients undergoing biopsies at the Egas Moniz University Clinic. Identify the most frequent oral lesions and their correlation with age, gender and anatomical location. Materials and methods: Retrospective analysis of 368 cases, referring to 350 male and female individuals, aged between 10 and 87 years old. Data from the Clinical Histories collected between 2008 and 2018 from individuals submitted to one or more biopsies performed at Egas Moniz University Clinic were analyzed. It was also recorded the location of the lesion, clinical diagnosis, histopathologic, smoking and ethyl habits. The histological diagnoses recorded were further grouped by pathology group. Results: The most affected gender was female, representing 55% of the sample. The most affected age group was 61-70 years and the least affected at 10-20 years. The most biopsied anatomical location was the gum (23.9%). Among the most prevalent groups are connective tissue injuries (32.1%), jaw cysts (15.8%) and white injuries (15.5%). The five most common pathological entities were fibroma, root cyst, oral lichen planus, hemangioma and leukoplakia. Assessing agreement shows that 74,5% of the cases were concordant and 25,5% were discordant. Conclusion: The study population was affected by 35 different histological entities, which proves the importance of conducting studies on the prevalence of oral expression lesions and highlights the importance of the role of the dentist in preventing and treating oral diseases.
Introduction: Lesions that occur in the oral cavity can be a challenge for the dentist. Histological (pathological) diagnosis or by complementary means of immunohistochemistry may be mandatory and often shown to enable definitive diagnosis. Objectives: To evaluate the agreement between the clinical and histopathologic diagnosis of oral lesions in patients undergoing biopsies at the Egas Moniz University Clinic. Identify the most frequent oral lesions and their correlation with age, gender and anatomical location. Materials and methods: Retrospective analysis of 368 cases, referring to 350 male and female individuals, aged between 10 and 87 years old. Data from the Clinical Histories collected between 2008 and 2018 from individuals submitted to one or more biopsies performed at Egas Moniz University Clinic were analyzed. It was also recorded the location of the lesion, clinical diagnosis, histopathologic, smoking and ethyl habits. The histological diagnoses recorded were further grouped by pathology group. Results: The most affected gender was female, representing 55% of the sample. The most affected age group was 61-70 years and the least affected at 10-20 years. The most biopsied anatomical location was the gum (23.9%). Among the most prevalent groups are connective tissue injuries (32.1%), jaw cysts (15.8%) and white injuries (15.5%). The five most common pathological entities were fibroma, root cyst, oral lichen planus, hemangioma and leukoplakia. Assessing agreement shows that 74,5% of the cases were concordant and 25,5% were discordant. Conclusion: The study population was affected by 35 different histological entities, which proves the importance of conducting studies on the prevalence of oral expression lesions and highlights the importance of the role of the dentist in preventing and treating oral diseases.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Concordância Diagnóstico Clínico Diagnóstico histológico Lesões orais