Surgical Science, 2013, 4, 210-212
http://dx.doi.org/10.4236/ss.2013.43039 Published Online March 2013 (http://www.scirp.org/journal/ss)
Concordance between Clinical and Histopathological
Diagnoses at Komfo Anokye Teaching Hospital Oral and
Maxillofacial Unit
Alexander Acheampong Oti
*
, Peter Donkor, Solomon Obiri-Yeboah, Michael Yelibora
Komfo Anokye Teaching Hospital, Kumasi, Ghana
Email:
*
aotiacheampong@yahoo.com
Received December 27, 2012; revised January 31, 2013; accepted February 10, 2013
ABSTRACT
Background: Accurate diagnosis of orofacial tumours is important as this determines the treatment options as well as
the eventual treatment outcome. Agreement between clinical and histopathological diagnosis becomes important in this
regard. Aims: The aim was to determine the level of agreement between clinical and histopathology diagnosis of orofa-
cial lesions. Method: This is a retrospective study of all histopathology reports seen at KATH maxillofacial unit.
Thedata collected included, clinical diagnosis and histological diagnosis. Results: A total of 567 histopathology reports
were evaluated. The percentage of agreement between clinical and histopathological diagnosis was 62.8%. Conclusion:
The agreement between clinical and histopathological diagnosis was high. However clinicians cannot rely on only the
clinical diagnosis in managing patients.
Keywords: Histopathology; Biopsy; Concordance; Diagnosis
1. Introduction
The maxillofacial region is a common anatomic site for
the development of infections, cysts and tumours of odon-
togenic or non-odontogenic origin. Oral mucosal lesions
are commonly encountered in clinical practice [1].
Squamous cell carcinoma constitutes a major health
problem in developing countries, representing a major
cause of death [2], although it represents only 2% - 4%
of all malignancies [3]. The major factor in the lack of
improvement in prognosis over the years is the fact that
cases of oral carcinoma are not diagnosed or managed
until they are advanced. This diagnostic delay may be
caused either by patients (who may not report unusual
oral features) or by health care workers (who may not
investigate observed lesions thoroughly). In another
study at KATH, Donkor [4] looked at a total of 50 pa-
tients who presented with squamous cell carcinoma; ma-
jority had advanced lesions which according to him ac-
counted for the poor treatment outcome.
In a UK study, it was observed that, the clinical diag-
nosis of general dental practitioners had a concordance of
49.4% with histological diagnosis, while specialists had
51.0%, giving an average of 50.6% for the two groups
[5]. This is similar to the findings of Williams [6] of
56.4% concordance for general practitioners. Seoane [7]
found a high level of agreement between oral and maxil-
lofacial surgeons and general dental practitioners on di-
agnosis of inflammatory, benign and precancerous lesions
but low level of agreement in diagnosing oral cancer.
There is currently no study that establishes a correla-
tion between clinical and histopathology diagnosis of
orofacial tumours and tumour-like lesions in Ghana. The
aim was to determine the level of agreement between cli-
nical and histopathology diagnosis of orofacial lesions.
In a developing country like Ghana where there is scar-
city of histopathological services, it is important to know
the accuracy of our clinical diagnosis to help in the man-
agement of orofacial lesions.
2. Method and Statistics
This was a retrospective study of all histopathology re-
ports seen at KATH maxillofacial unit from 1999 to Oc-
tober 2010. This study looked at the clinical and histopa-
thological diagnosis of biopsy specimen. Data was en-
tered into excel spreadsheet for cleaning and then to
SPSS for descriptive analysis of data.
3. Results
A total sample size of 567 met the inclusion criteria for
the histopathological and clinical diagnosis study. The
age range was 5 to 84 years with a mean age of 34.6 (SD
*
Corresponding author.
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