Background:Oral carcinogenesis is a multi-step process. Broadly, oral squamous cell carcinoma (OSCC) can be well-, moderately-or poorly-differentiated, and either keratinizing or non-keratinizing. Most cases are moderately to poorly-differentiated. Precursor lesions (dysplasia) can be categorized into mild, moderate, or severe (carcinoma in situ).In the present study, the pattern of keratin expression in oral squamous cells during carcinogenesis is vividly analysed. Materials and Methods: Samples in the form of scraped and exfoliated cytosmear were collected from the affected sites of the clinically diagnosed 136 oral cancer patients and were immediately fixed in acetoalcohol (1:3). The wet fixed smears were stained by routine Papanicolaou's staining protocol and Giemsa's solution. Stained tissues were studied under the microscope. Results: Cytological pleomorphism is a unique feature observed during carcinogenesis. There appears to be a spectrum of degrees of keratinization rather than distinct types, and the degree of keratinization is reflected in the degree of packing and orientation of keratin filaments. It is presumed that alteration in the architectural regularity of the cell membrane is an important aspect of keratinization which leads to cytological pleomorphism during oral carcinogenesis. Conclusion: Pattern of keratinization alongwith cytological pleomorphism in exfoliated epithelial squamous cells has a practical utility in the diagnosis and early detection of oral cancer during carcinogenesis.

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Background: Use of exfoliative cytology and cyto-analysis is a useful early diagnostic method for epithelial atypia and for human oral neoplasm. A rare occurrence of cytological atypia appeared to be anuran tadpole larva, named as keratinized tadpole cell (KTC) is analyzed cytomorphometrically with a cytodiagnostic approach. Materials and Methods: In a case-control study, exfoliated scraped cytosmears were collected from the affected sites of the clinically diagnosed 136 oral cancer patients over the pre-cleaned microslides and immediately fixed in acetoalcohol. Cytosmears were stained with routine Papanicolaou's stain and counterstained with the Giemsa's solution. One thousand cells were observed and the KTCs were scored from each stained sample following standard criteria. Findings were statistically analyzed, interpreted and correlated with the oral sites, sex and nature of addiction. Results: Keratinized tadpole cells (KTCs) exhibit both cytological and nuclear pleomorphism. Almost all KTCs are moderately differentiated with a well defined head and tail in each. Usually, nucleus is confined to the head part of the cell and tail contains cytoplasm only. Keratinized cytoplasm, nuclear pleomorphism, presence of nuclear haloes, micronucleation, multinucleation and increased nuclear-cytoplasmic ratios (N/C) in keratinized tadpole cells are the clear indication of malignancy so far as cytopathology is concerned. Conclusion: Appearance of KTCs in the epithelia of oral neoplasm has a practical utility in early detection and diagnosis of the oral cancer patients.

Background: Use of exfoliative cytology and cyto-analysis is a useful early diagnostic method for epithelial atypia and for human oral neoplasm. Rare occurrences of cytological atypia appear to be very thin, elongated, fibre like structures in oral epithelia is named as keratinized fiber cells (KFCs). In the present study, the aim is to quantify the KFCs and to analyze it morphometrically with a cytodiagnostic approach. Materials and Methods: In a case-control study, exfoliated scraped cytosmears were collected from the affected sites of the clinically diagnosed 136 oral cancer patients over the pre-cleaned microslides and immediately fixed in acetoalcohol. Cytosmears were stained with routine Papanicolaou's stain and counterstained with the Giemsa's solution. Out of one thousand screened cells, the KFCs were scored from each stained sample following standard criteria. Cytomorphometry was done by using computer-assisted Cat Cam 1.30 (1.3 Mega Pixel) microscope camera of Catalyst Biotech ® (Maharashtra, India). Findings were statistically analyzed, interpreted and correlated with the oral sites, sex and nature of addiction. Results: Keratinized fiber cells (KFCs) exhibit both cytological and nuclear pleomorphism. Usually, two types of KFCs-named as Large Keratinized fiber cells (LKFCs) and small Keratinized fiber cells (SKFCs) were observed in 53.76% of total collected samples from the premalignant and malignant cases. Almost all KFCs are moderately differentiated with an elongated fiber contour in each and are the pleomorphic form of normal oral squamous cells. Keratin expression in the cytoplasm in KFCs indicates epidermoid origin. The terminal ends are either pinpointed or narrowly blunt. The nucleus is also found to be elongated inside the cytoplasm of KFCs. In rare cases, the nucleiof the KFCs may be either polarized or ink-dot shaped. Cytological as well as nuclear pleomorphism, pattern of keratiniztion, hyperchromasia and increased nuclear-cytoplasmic (N/C) ratios in KFCs are of cytopathological importance and are the signs and clear indication of malignancy. Conclusion: Genesis of KFCs in the epithelia of oral neoplasm is a sign of neo-fibrosis. Pattern of keratiniztion, hyperchromasia, nuclear pleomorphism and increased nuclear-cytoplasmic ratios (N/C) in KFCs are of cytopathological importance and thus appearance of KFCs in oral epithelia has a practical utility in early detection and diagnosis of the oral cancer patients.