Cytomorphometric analysis of exfoliated buccal cells to evaluate the malignant changes in individuals with tobacco smoking and chewing habits

Bharani Syamala, Ravi T Chitturi, Poosarala Chandrasekhar, K Lalith Prakash Chandra, K Kiran Kumar, BV Ramana Reddy

Journal of Dr. NTR University of Health Sciences 2017 6(3):143-148

Background: Tobacco is one of the leading causes for potentially malignant disorders (PMDs) and oral squamous cell carcinoma (OSCC) which stands 6th among all malignancies in the world. To prevent the high mortality rates and improve the five-year survival rates of patients with OSCC, it is very important to diagnose PMDs early. Exfoliative cytology combined with quantitative analysis such as cytomorphometry can be an important tool for early detection and diagnosis of these lesions. Aim: The aim of this study was to evaluate the quantitative changes in cytological buccal smears of tobacco smokers and chewers with that of the normal healthy individuals to assess the malignant changes by using cytomorphometric parameters such as cell diameter (CD), nuclear diameter (ND), and nuclear–cytoplasmic ratio (N/C). Materials and Methods: The study was carried out among 120 individuals. Group I consisted of 40 tobacco smokers, group II consisted of 40 tobacco chewers, and group III consisted of 40 controls who did not have a habit of tobacco smoking and chewing with apparently healthy appearing mucosa. Smears were made for all individuals and stained with Papanicolou technique. CD, ND, and N/C were calculated using an image analysis software after selecting 200 cells from each smear. All the parameters were subjected to statistical analysis using one-way analysis of variance and Scheffes multiple post hoc procedure. Results: There was a statistically significant reduction in CD and increase in ND and N/C of tobacco chewers and smokers when compared to that of controls. Age and sex did not have any influence on any of the cytomorphometric parameters. Conclusion: The habit of tobacco smoking and chewing causes quantitative cellular and nuclear changes in the squames of buccal mucosal epithelial cells, which shows a cause–effect relationship between tobacco and quantitative changes in the cells. Therefore, exfoliative cytology with the application of quantitative techniques can be used as a valuable diagnostic tool for detecting PMDs and malignant lesions.

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