Year : 2018

Volume : Volume 9

Issue : Issue 1

Address for correspondence :
Dr. Nilesh Patel.
paresh8205@gmail.com

Abstract

Aim:  The objective of the present study was designed to examine the cellular changes induced by tobacco chewing in keratinocytes of buccal mucosa as revealed by cytomorphometry. Materials and Method: We compared the cellular diameter (CD), nuclear diameter (ND) and the ratio of nuclear diameter to cellular diameter (ND/CD), as well as the cellular area  (CA), nuclear area (NA) and the ratio of nuclear area  to cellular area (NA/CA) of buccal mucosa squames of normal subjects (N), with buccal mucosa squames of tobacco users without lesion (A), with tobacco-lime lesion(B), with tobacco chewing habit and premalignant lesion/condition(C), and oral squamous cell carcinoma (D). The study group consisted of 100 patients divided into five groups (N, A, B, C and D) between the ages of 21 and 75 years. Results: The mean of the cellular diameter of group N, A, B, C, and D was 102.46 ± 1.77μm, 91.55 ± 2.74μm, 87.30 ± 1.10μm 84.84 ± 5.49μm, 60.09 ± 1.33 μm respectively (p<0.01). The mean of the nuclear diameter of group N, A, B, C, and D was 11.8 ± 0.22μm, 13.48 ± 0.63μm, 14.01 ± 0.33μm, 13.93 ± 0.52μm, 19.59 ± 0.23μm respectively (p<0.01). The mean of the ratio of nuclear diameter to cellular diameter of group N, A, B, C, and D was 0.115 ± 0.000, 0.147 ± 0.008, 0.161 ± 0.005, 0.165 ± 0.007, 0.326 ± 0.008 respectively (p<0.01). The mean of the cellular area of group N, A, B, C, and D was 8743.30 ± 311.85μm2, 7258.72 ± 91.64μm2, 5546.53 ± 363.12μm2, 5125.91 ± 347.33μm2, 4082.08 ± 143.77μm2 respectively. (p<0.01). The mean of the nuclear area (in micrometers) of group N, A, B, C, and D was 104.22 ± 4.38 μm2, 119.63 ± 2.56 μm2, 137.50 ± 2.81 μm2, 145.40 ± 19.23 μm2, 181.68 ± 3.90 μm2 respectively (p<0.01). The mean of the ratio of nuclear area to cellular area of group N, A, B, C, and D was 0.012 ± 0.001, 0.016 ± 0.000, 0.025 ± 0.001, 0.028 ± 0.003, 0.045 ± 0.001 respectively (p<0.01). Univariate analysis of variance (ANOVA) showed a significant group effect for cellular diameter, nuclear diameter ratio of nuclear diameter to cellular diameter, cellular area, nuclear area and ratio of nuclear area to cellular area Multiple comparison tests by Tukey–HSD procedure revealed a significant decrease in the mean cellular diameter, increase in the nuclear diameter and ratio of nuclear diameter to cellular diameter and same with cellular area and nuclear area respectively.  Conclusions: Cytomorphometric changes could be the earliest indicators of cellular alterations. There is progressive decrease in cellular diameter and area, increase in nuclear diameter and area and increase in ratio of nuclear diameter to cellular diameter and  nuclear area to cellular area in smears from all tobacco users, as compared to normal subjects. This indicates that there could be cause–effect relationship between tobacco and quantitative alterations.

Keywords: exfoliative cytology, cytomorphometry, oral cancer, tobacco.