Effect of smoking on cytomorphology of buccal mucosal cells: Can it be a non invasive tool to detect precancerous changes in smokers?

Abstract

Introduction: Oral cancer is one of the cancers highly prevalent in India affecting people with habit of using tobacco and alcohol. By detecting cytomorphological changes in buccal mucosa could increase the chances of earlier detection of premalignant and malignant lesions and thereby early intervention. Aim: To assess and compare the cytomorphological changes in buccal mucosa cells amongst smoker and non-smoker group and assess these findings in smokers with duration of exposure to smoking by dividing them as per pack year groups. Materials and Methods: This comparative study was carried out on 80 individuals consisting of 40 male cases having history of Cigarette or Bidi smoking and 40 controls as per inclusion and exclusion criteria. . For finding effect of smoking exposure severity, smokers were further divided in three groups based on Pack Year like group 1 with pack Year 10. After taking written informed consent, sample was taken from buccal mucosa and then slide was stained with papnicoalaou stain. Total of 100 cells were scanned to find cytomorphological changes like Binucleated cell, pyknosis, perinuclear halo, cytoplasmic granules, karyolysis, karyorrhexis, cytoplasmic vacuoles and micronuclei presence. All data were noted and subjected to stastical analysis. Results: It was found that there was significant difference for Mean values of binucleation, pyknosis, perinuclear halo, cytoplasmic granules, karyolysis, karyorrhexis and micronuclei in buccal mucosa of smokers and non-smokers. We found that pyknosis, cytoplasmic granules and micronuclei were presented with significance in smoker groups having pack year 10. Conclusion: The present study indicates that almost all cytomorphological findings were high in smokers than non-smokers. All above findings we got were present in healthy mucosa of smoker and such findings are also observed in increased severity in premalignant conditions like leukoplakia. So it is possible to pick up these findings e