Oral potentially malignant disorders: clinical-pathological correlations in a dental institution in North Carolina

To investigate the prevalence and diagnostic accuracy of oral potentially malignant disorders (OPMDs) in North Carolina, focusing on the agreement between clinical impressions and microscopic diagnoses.

This retrospective study analyzed 76 patient records from the East Carolina University Oral Pathology Biopsy Service. Clinical impressions of OPMDs, including leukoplakia, erythroplakia, and chronic ulcers, were compared with histopathological diagnoses. Data were collected using HIPAA-compliant software, and Cohen's Kappa was used to evaluate diagnostic agreement.

The patient cohort had a mean age of 62.2 years, with 65.7% male and 60.5% identifying as Caucasian. The most common lesion locations were the lateral tongue (32.8%) and alveolar ridge mucosa (27.6%). Minimal agreement was observed between clinical impressions and microscopic diagnoses (Kappa: 0.0266 ± 0.0682, P = .6965). Smoking and alcohol use were significantly associated with higher grades of oral epithelial dysplasia.

The study highlights significant diagnostic challenges in identifying OPMDs based on clinical impressions alone, emphasizing the need for histopathological evaluation. Improved diagnostic training and public health interventions are essential to enhance early detection and reduce the burden of oral cancer in North Carolina.