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Inter-observer Variability in the Diagnosis of Proliferative Verrucous Leukoplakia: Clinical Implications for Oral and Maxillofacial Surgeon Understanding: A Collaborative Pilot Study.
Upadhyaya, Jasbir D; Fitzpatrick, Sarah G; Cohen, Donald M; Bilodeau, Elizabeth A; Bhattacharyya, Indraneel; Lewis, James S; Lai, Jinping; Wright, John M; Bishop, Justin A; Leon, Marino E; Islam, Mohammed N; Seethala, Raja; Padilla, Ricardo J; Carlos, Roman; Müller, Susan; Thompson, Lester D R.
Afiliación
  • Upadhyaya JD; Section of Diagnostic Sciences, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, 2800 College Avenue, Alton, IL, 62002, USA. jupadhy@siue.edu.
  • Fitzpatrick SG; Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
  • Cohen DM; Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
  • Bilodeau EA; Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
  • Bhattacharyya I; Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
  • Lewis JS; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Lai J; Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
  • Wright JM; Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX, USA.
  • Bishop JA; Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Leon ME; Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
  • Islam MN; Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
  • Seethala R; Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
  • Padilla RJ; Department of Diagnostic Sciences, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
  • Carlos R; Pathology Division, Centro Clínico de Cabeza y Cuello, Guatemala City, Guatemala.
  • Müller S; Emory University School of Medicine, Atlanta Oral Pathology, Decatur, GA, USA.
  • Thompson LDR; Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills, CA, USA.
Head Neck Pathol ; 14(1): 156-165, 2020 Mar.
Article en En | MEDLINE | ID: mdl-30972634
The use of diverse terminology may lead to inconsistent diagnosis and subsequent mistreatment of lesions within the proliferative verrucous leukoplakia (PVL) spectrum. The objectives of this study were: (a) to measure inter-observer variability between a variety of pathologists diagnosing PVL lesions; and (b) to evaluate the impact of diverse terminologies on understanding, interpretation, and subsequent treatment planning by oral and maxillofacial surgeons (OMFS). Six oral pathologists (OP) and six head and neck pathologists (HNP) reviewed 40 digitally scanned slides of PVL-type lesions. Inter-observer agreement on diagnoses was evaluated by Fleiss' kappa analysis. The most commonly used diagnostic terminologies were sent to ten OMFS to evaluate their resulting interpretations and potential follow-up treatment approaches. The overall means of the surgeons' responses were compared by Student t test. There was poor inter-observer agreement between pathologists on the diagnosis of PVL lesions (κ = 0.270), although there was good agreement (κ = 0.650) when diagnosing frankly malignant lesions. The lowest agreement was in diagnosing verrucous hyperplasia (VH) with/without dysplasia, atypical epithelial proliferation (AEP), and verrucous carcinoma (VC). The OMFS showed the lowest agreement on identical categories of non-malignant diagnoses, specifically VH and AEP. This study demonstrates a lack of standardized terminology and diagnostic criteria for the spectrum of PVL lesions. We recommend adopting standardized criteria and terminology, proposed and established by an expert panel white paper, to assist pathologists and clinicians in uniformly diagnosing and managing PVL spectrum lesions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Patología Clínica / Lesiones Precancerosas / Leucoplasia Bucal Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Revista: Head Neck Pathol Asunto de la revista: NEOPLASIAS / PATOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Patología Clínica / Lesiones Precancerosas / Leucoplasia Bucal Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Revista: Head Neck Pathol Asunto de la revista: NEOPLASIAS / PATOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos