Concordancia clínica y patológica en tumores conjuntivalesAnálisis de 195 casos

  1. Luis García-Onrubia 23
  2. G.E. Pacheco-Callirgos 2
  3. C. García-Álvarez 2
  4. M.F. Muñoz-Moreno 2
  5. E. García-Lagarto 2
  6. A. Almaraz-Gómez 1
  7. M.A. Saornil-Álvarez 2
  1. 1 Universidad de Valladolid

    Universidad de Valladolid

    Valladolid, España


  2. 2 Hospital Universitario de Valladolid

    Hospital Universitario de Valladolid

    Valladolid, España


  3. 3 Moorfields Eye Hospital NHS Foundation Trust

    Moorfields Eye Hospital NHS Foundation Trust

    Londres, Reino Unido


Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Year of publication: 2023

Volume: 98

Issue: 8

Pages: 440-447

Type: Article


More publications in: Archivos de la Sociedad Española de Oftalmologia


Purpose The present study aims to assess the agreement between clinical and pathological diagnosis in conjunctival tumours in a specialist ocular oncology unit. Methods A retrospective study of consecutive patients with conjunctival tumours diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid was performed from 1992 to 2017. Tumours were classified according to their origin (epithelial, melanocytic, lymphoid, and others) and degree of malignancy (benign, premalignant, and malignant). A biopsy was performed in cases of symptomatic or growing lesions. Cohen's kappa (κ) statistics was used as an indicator of agreement between clinical and pathological diagnosis. Results Of 462 consecutive patients, a biopsy was required in 195 (42.2%). The agreement with the pathological diagnosis was successful in 154 (79%) cases. Analysis according to the grade of malignancy showed the lowest rate of agreement among benign (n = 83; 91.6%) and premalignant (n = 62; 90.3%) lesions, with a total agreement in malignant lesions (n = 50; 100%); the Cohen's kappa coefficient (κ) was 0.90. The highest rates of concordance were found in epithelial, melanocytic and soft tissue lesions with κ values of 1, 0.8 and 1, respectively. The worst rate of concordance was found in lymphoid lesions with a κ value of 0.3. Conclusions Most of the conjunctival tumours were correctly identified clinically; benign and malignant lesions showed the highest rate of accuracy; however, premalignant tumours can hide micro-invasive diseases that can go unnoticed on clinical examination. The biopsy is essential for accurate diagnosis and treatment.