Abstract
Objectives: During the present investigation, a unique type of pleomorphic cytological atypia- named as nonkeratinized malignant squamous cell (NMSC) was frequently observed in the exfoliated cytosmears of the oral cancer patients. Details of these peculiar atypical, pleomorphic cells have not been reported earlier. Therefore, an attempt has been undertaken to find out the practical utility of NMSCs during difficult diagnoses and in early detection of oral squamous cell carcinoma (OSCC) cases through cytomorphometric analysis. Materials and Methods: In a hospital-based case-control study exfoliated scrape smears were collected from the clinically diagnosed 136 patients suffering from precancerous lesions and cancerous cases and a parallel set of 136 samples were also collected from the non-addicted and non-cancerous healthy individuals considered as control group. Wet fixed smears were stained by adopting Papanicolaou’s staining protocol and counter-stained with Giemsa’s solution. Out of one thousand screened cells, frequently observed NMSCs were scored. Cytomorphometry was done by using computer-assisted Cat Cam 1.30 (1.3 Mega Pixel) Microscope Camera® fitted with hund®-H500 research binocular microscope. The findings were statistically analyzed and interpreted by using software package PAleontological Statistics (PAST)® Version 2.17 with respect to age groups, degree of pathogenicity, oral sites and sexes. Results: Cytomorphometrically, the cellular parameters (mean length, breadth and area) of the NMSC were found to be in decreased state and nuclear parameters are in increased state. The quantitative parameters of the NMSCs were significantly (p ≤ 0.01) decreased with increasing age groups. Cytomorphometrically, the nuclearcytoplasmic (N/C) ratio of the NMSC was found to be 1:1 in both sexes. Conclusion: Extreme reduction of cellular diameter and increased nuclear diameter in each NMSC, lead to cellular non-keratinization, hyperchromasia and increased N/C ratios in both sexes indicate the state of malignancy. Thus, the present finding has a practical utility in early detection and diagnosis of the OSCC patients.
Highlights
Oral squamous cell carcinoma (OSCC) is one of the most common malignancies as well as a major cause of cancer morbidity and mortality, worldwide [1]
Cytomorphometrically, the cellular parameters of the nonkeratinized malignant squamous cell (NMSC) were found to be in decreased state and nuclear parameters are in increased state
Extreme reduction of cellular diameter and increased nuclear diameter in each NMSC, lead to cellular non-keratinization, hyperchromasia and increased N/C ratios in both sexes indicate the state of malignancy
Summary
Oral squamous cell carcinoma (OSCC) is one of the most common malignancies as well as a major cause of cancer morbidity and mortality, worldwide [1]. Detection of premalignant and malignant lesions can significantly reduce the morbidity and mortality associated with oral cancer. In spite of various techniques applied so far, cytopathology has been accepted as a standard protocol for early detection of oral cancer. Cytological pleomorphism is a common feature during oral carcinogenesis. Cellular and nuclear anomalies are frequently observed in the exfoliated cytosmears of human oral neoplasm [2].
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