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      Estandarización en la Observación y Clasificación de Lesiones Epiteliales Premalignas y Malignas Translated title: Standardization in the Observation and Classification of Premalignant and Malignant Epithelial Lesions

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          Abstract

          Los criterios histológicos para determinar el grado de displasia, la clasificación de Broders y el frente de invasión tumoral (FIT) son parámetros subjetivos no cuantificables que pueden indicar el grado de evolución de displasias y carcinomas. Un factor importante a considerar durante la valoración histológica, es la variabilidad del diagnóstico entre patólogos. El objetivo es estandarizar los criterios y determinar la variabilidad intra e inter observador en el diagnóstico de displasias y COCE. Se seleccionaron y estandarizaron los criterios morfológicos para el diagnóstico y se revisaron los casos seleccionados aleatoriamente por tres patólogos bucales (30 displasias y 30 carcinomas) del Laboratorio de Patología Clínica y Experimental de la DEPeI de la FO, UNAM. Cada patólogo analizó y registró los parámetros establecidos para displasia, COCE y FIT en 2 ocasiones. Se aplicó el test Kappa para valorar la concordancia intra e inter observador. El Observador 1 v/s el 2 obtuvo una concordancia para COCE de 0,75 y en displasias de 0,60 e intraobservador de 0,90. El observador 2 v/s el 3 presentó una concordancia para COCE de 0,75 y en displasias de 0,59 e intraobservador de 0,91. El Observador 3 Vs el 1 tuvo una concordancia para COCE de 0,77, y en displasias de 0,59 e intraobservador de 0,92. La concordancia intraobservador e interobservador en COCE fue de buena a excelente, pero en displasias fue aceptable confirmando que su evaluación presenta mayor grado de dificultad. Con una adecuada estandarización se puede obtener una buena concordancia entre patólogos.

          Translated abstract

          In the histological criteria for determining the degree of dysplasia, the Broders classification and the front of tumor invasion (FTI) are unquantifiable subjective parameters that may indicate the degree of development of carcinomas. An important factor to consider during the histological evaluation is the variability in the diagnosis of pathologists. The objective to standardize criteria and determine the intra and inter-observer variability in the diagnosis of dysplasias and OSCC. We selected and standardized morphological criteria for the diagnosis, and the cases were reviewed randomly by three oral pathologists (30 dysplasias and 30 carcinomas) from the Laboratory of Clinical and Experimental Pathology of the FO DEPeI, UNAM. Each pathologist analyzed and recorded the parameters for dysplasia and OSCC FIT on two occasions. Kappa test was applied to assess intra and inter-observer agreement. Observer 1 v/s 2 match for OSCC was 0.75, 0.60 for dysplasias and intra observer 0.90. Observer 2 v/s 3 presented a concordance of 0.75 for OSCC, 0.59 for dysplasias and intra-observer 0.91. Observer 3 v/s observer 1 for OSCC was 0.77, 0.59 for dysplasias and intra-observer 0.92. Intra observer and inter-observer concordance in OSCC were good or excellent, but in dysplasia was acceptable, confirming that its assessment showed the greatest difficulty with proper standardization we can obtain a better consensus between pathologists.

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          Cáncer y precáncer bucal

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            Why oral histopathology suffers inter- observer variability on grading oral epithelial dysplasia: an attempt to understand the sources of variation

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              Intraexaminer And interexaminer reliability in the diagnosis of oral epithelial dysplasia

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ijmorphol
                International Journal of Morphology
                Int. J. Morphol.
                Sociedad Chilena de Anatomía (Temuco )
                0717-9502
                September 2011
                : 29
                : 3
                : 706-710
                Affiliations
                [1 ] Universidad Nacional Autónoma de México Mexico
                [2 ] Universidad Nacional Autónoma de México Mexico
                [3 ] Universidad Nacional Autónoma de México Mexico
                Article
                S0717-95022011000300007
                10.4067/S0717-95022011000300007
                2a0b3e8e-96a3-4834-bce6-92facd44d12f

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Chile

                Self URI (journal page): http://www.scielo.cl/scielo.php?script=sci_serial&pid=0717-9502&lng=en
                Categories
                ANATOMY & MORPHOLOGY

                Anatomy & Physiology
                Standardized criteria,Inter-observer variability,Diagnostics variability,Epithelial lesions,Estandarización de criterios,Variabilidad interobservador,Variabilidad Diagnóstica,Lesiones epiteliales

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