Oral biopsies in a Portuguese population: A 20-year clinicopathological study in a university clinic

Abstract

Background: Performing a biopsy is very important in oral medicine and the anatomopathological examination is fundamental to obtain or to confirm the diagnosis in oral and maxillofacial pathology. The purpose of this study is to analyse the frequency and characteristic patterns of biopsied oromaxillofacial lesions in a Portuguese population.

Material and methods: A descriptive statistical analysis of the data from the anatomopathological reports of the biopsies performed between 1999 and 2019 at the university clinic of the Faculty of Dental Medicine of the University of Lisbon was performed, regarding the patient's gender and age, type of biopsy, location of lesions, clinical and histological diagnosis, and the results were obtained. Association relationships were studied using the chi-square test and the Kruskal-Wallis test to correlate variables. P<0.05 was considered statistically significant.

Results: From a total sample of 1448 patients, 826 (57.1%) were female, 610 (42.1%) were male, and 12 (0.8%) had no gender information, with a mean age of 50.14 years (standard deviation ± 17.61). The preferred location was the buccal mucosa, vestibule fundus and alveolar mucosa (20.7%). Benign lesions (BL) were the most common, in 82,8% of the cases, followed by oral potentially malignant disorders (OPMD) in 15,5%, and finally, malignant lesions (ML) in 1.7%. Focal fibrous hyperplasia was the most frequent diagnosis in the total sample (25.6%). In the young group, the most common entity was mucocele (34.0%), with a predominance of the lower lip (32.9%). In OPMD, leukoplakia was the most frequently diagnosed (48,7%). The most common ML was squamous cell carcinoma (92.0%), appearing mainly in the tongue (34.8%). A statistically significant relation between ML and older age was found.

Conclusions: This study included biopsies analysed over a period of 20 years, being BL the main pathology to affect the oral cavity. Although less frequent, OPMD and ML should not be neglected and must be correctly diagnosed and treated. Key words:Oral biopsies, Oral and maxillofacial pathology, Oral medicine, Clinicopathological analysis, Epidemiological study, University clinic.

Figure 1

The 5 most common histological diagnoses according to gender: a) male and b) female.

Figure 2

The 3 most common histological diagnoses according to the age group: a) young patients, b) adult patients, and c) elderly patients.

Figure 3

Type of biopsy according to the nature of lesion.

Figure 4

Clinical-pathological concordance in different types of lesions.