Cytomorphometric evaluation of the epithelial cells of buccal mucosa in smokeless tobacco users: An In vivo study

Abstract

Background: Smokeless tobacco (SLT) used in various formulations induces certain oral mucosal lesions commonly known as oral potentially malignant disorders (OPMDs). The prevalence of transformation of OPMD to oral squamous cell carcinoma is high. Thus, early diagnosis and prompt intervention may prevent this progression and further malignant transformation. Aim and Objectives: We aimed to assess the effect of tobacco chewing on epithelial cells of buccal mucosa in SLT users using cytomorphometry. Materials and Methods: The study group comprised 90 patients divided into three groups (A, B, and C). The comparison of the cellular diameter, nuclear diameter, and the nuclear–cellular diameter ratio of epithelial cells of buccal mucosa of control group (A) with tobacco chewing habit but no oral mucosal lesion (B) and tobacco chewing habits and oral mucosal premalignant lesions (C) was carried out. Results: Univariate analysis of variance showed a significant group effect for cellular diameter, nuclear diameter, and ratio of nuclear–cellular diameter. Multiple comparison tests by Tukey's honestly significant difference procedure revealed a significant decrease in the mean cellular diameter, increase in the nuclear diameter, and ratio of nuclear–cellular diameter. Conclusion: Cytomorphometric changes could be the earliest indicators of cellular alterations. There is a progressive decrease in cellular diameter, increase in nuclear diameter, and ratio of nuclear–cellular diameter in epithelial cells of buccal mucosa from all smokeless tobacco users, as compared to normal controls. This indicates that there could be cause–effect relationship between tobacco and quantitative alterations.