Cytomorphometric analysis of exfoliated buccal mucosal cells in smokers and patients with hypertension: A quantitative analysis

Abstract

Aim: To examine and estimate cytomorphometric changes by using parameters such as cell area (CA), nuclear area (NA), cell diameter (CD), nuclear diameter (ND), and nuclear-cytoplasmic ratio (N/C) in exfoliated buccal mucosal cells in smokers, patients with hypertension, and healthy individuals by using Papanicolaou stain. Materials and Methods: This quantitative analysis was performed on totally 120 individuals who were randomly selected and were divided into four groups. Group 1: 30 healthy individuals free of hypertension and without any smoking habit comprised the control group; Group 2: 30 individuals with smoking habit and without hypertension; Group 3: 30 individuals with smoking habit and with hypertension; and group 4: 30 individuals with hypertension and without smoking habit. Buccal smears were taken and stained by Papanicolaou stain. Image analysis of 50 cells was done at 40× magnification with a digital image capture analysis software system (ProgRes capture pro, version 2.8.8). The obtained parameters were statistically compared among the groups by one-way ANOVA test and Kruskal–Wallis test. Results: Statistically significant increase in NA, ND, and N/C ratio values were found in smokers and smokers with hypertension, and minimal change was observed in patients with hypertension alone when compared with normal mucosa. Conclusion: Smoking habit alone and patients with hypertension along with smoking habit show significant cytomorphometric changes. The combined use of exfoliative cytology and cytomorphometric analysis gives an added advantage in monitoring clinically suspect lesions and early detection of malignancy in high-risk individuals such as smokers.