Tobacco and its end products are considered as the main etiological factors responsible for the pathogenesis of oral cancer. Various cytological alterations have been reported with tobacco usage like change in the nuclear size, cell size, nuclear to cytoplasmic ratio, nuclear shape etc. Of these parameters, the nuclear size, cytoplasmic size and their ratio have been shown to be significant. The objective of the present study is to assess the effect of tobacco chewing on buccal mucosa of 75 patients using cytomorphometry. Comparison was made between cytoplasmic area, nuclear area and the ratio between nuclear to cytoplasmic area of buccal squames of 25 normal subjects (N), 25 subjects using some form of tobacco for more than 5 years but not having any oral lesion (H) and 25 patients having habit of using tobacco for more than 5 years and having tobacco associated oral lesion (L). The statistical analysis of the result showed variation in the cytoplasmic area, nuclear area and ratio between nuclear and cytoplasmic area in the buccal smears taken from Normal, Habit and Lesional groups. Application of quantitative techniques to cytological smears could possibly improve the diagnostic value of oral exfoliative cytology.

Keywords: Cytomorphometry, exfoliated mucosal cells, premalignant lesions.

1. Lewin F, Norell SE, Johansson H, Gustavsson P,Cwennerberg J, Biörklund A, Rutqvist LE, Smoking tobacco, oral snuff, and alcohol in the etiology of squamous cell carcinoma of the head and neck: a population based case-referent study in Sweden, Cancer, 1998, 82(7):1367–1375.
2. Brickley MR, Cowpe JG, Shepherd JP, Performance of a computer simulated neural network trained to categorise normal, premalignant and malignant oral smears, J Oral Pathol Med, 1996, 25(8):424–428.
3. Khandelwal S, Solomon MC. Cytomorphological Analysis of Keratinocytes in Oral Smears from Tobacco Users and Oral Squamous Cell Carcinoma Lesions — A Histochemical Approach. Int J Oral Sci, 2(1): 45–52, 2010.
4. Kaugars GE, Brandt RB, Chan W, Carcaise–Edinboro P, Evaluation of risk factors in smokeless tobacco-associated oral lesions, Oral Surg Oral Med Oral Pathol, 1991,72(3):326–331.
5. Parkin DM, Bray F, Ferlay J, Pisani P (2001). Estimating the world cancer burden: 2000 Globocan. Int J Cancer, 94(2): 153–156.
6. Alka Harish Hande, Minal S Chaudhary. Cytomorphometric Analysis of Buccal Mucosa of Tobacco Chewers. Romanian Journal of Morphology and Embryology 2010, 51(3):527–532
7. Mehrotra R, Gupta A, Singh M, Ibrahim R, Application of cytology and molecular biology in diagnosing premalignant or malignant oral lesions, Mol Cancer, 2006, 5:11.
8. Cowpe JG, Longmore RB (1981). Nuclear area and Feulgen DNA content of normal buccal mucosal smear. J Oral Pathol, 10(2): 81–86.
9. Montgomery PW, von Hamm E (1951). Study of exfoliative cytology in patients with carcinoma of the oral mucosa. J Dent Res, 30(3): 308–313.
10. Hillman RW, Kissin B, Oral cytologic patterns in relation to smoking habits. Some epithelial, microfloral, and leukocytic characteristics, Oral Surg Oral Med Oral Pathol, 1976, 42(3):366–374.
11. Ogden GR, Cowpe JG, Green MW, Quantitative exfoliative cytology of normal buccal mucosa: effect of smoking, J Oral Pathol Med, 1990, 19(2):53–55.
12. Cowpe JG, Longmore RB, Green MW, Quantitative Exfoliative Cytology Of Normal Oral Squames: An Age, Site And Sex-Related Survey, J R Soc Med, 1985, 78(12):995–1004.
13. Cowpe JG, Longmore RB, Green MW, Quantitative Exfoliative Cytology Of Abnormal Oral Mucosal Smears, J R Soc Med, 1988, 81(9):509–513.
14. Ramaesh T, Mendis BR, Ratnatunga N, Thattil RO, Cytomorphometric Analysis Of Squames Obtained From Normal Oral Mucosa And Lesions Of Leukoplakia And Squamous Cell Carcinoma, J Oral Pathol Med, 1998, 27(2):83–86.
15. Einstein TB, Sivapathasundharam B, Cytomorphometric Analysis Of The Buccal Mucosa Of Tobacco Users, Indian J Dent Res, 2005, 16(2):42–46.
16. Frost JK (1997). Pathologic processes affecting cells from inflammation to cancer. //Bibbo M, ed. Comprehensive cytopathology. 2 ed. Philadelphia: WB Saunders company, p 845.
17. Cançado RP, Yurgel LS, Filho MS (2004). Comparative analysis between the smoking habit frequency and the nucleolar organizer region associated protein in exfo- liative cytology of smokers’ normal buccal mucosa. Tob Induc Dis, 15, 2(1): 43–49.

Dr Mani Madan

Flat 505, Ashoka Apartment, 5 Way Lane

Near Jopling Road, Hazratganj, Lucknow, U.P., India

Mobile no: 9935394203, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.