Exfoliative cytology of buccal squames: A quantitative cytomorphometric analysis of patients with diabetes

Abstract

Background:Diabetes is a third leading cause of mortality and morbidity in the world. Diabetes is one of the most common endocrine metabolic disorders and its prevalence has been increasing worldwide. Oral exfoliative cytology may be a more appropriate adjunctive diagnostic tool in conditions like diabetes mellitus, where the invasive techniques lose viability.Aims:The purpose of this study is to analyze the cytomorphometric changes in the exfoliated cells of the oral mucosa, as an adjunct to the diagnosis of diabetes.Materials and Methods:Smears were taken from the buccal mucosa of 30 diabetes patients (study group) and 30 healthy individuals (control group). All the smears were stained with rapid Papanicolaou stain (PAP). In the PAP smears, the nuclear area (NA), cytoplasmic area (CA), and cytoplasmic-to-nuclear ratio (CNR) were evaluated for 50 cells in each smear, using the Image Analysis Software (Magnus Pro™) and research microscope (Lawrence and Mayo™).Results:The results showed that the mean NA was significantly higher (P < 0.001) in the study group, whereas, the mean CA did not exhibit a statistically significant difference (P > 0.001). The mean CNR was significantly lower in the study group (P < 0.001).Interpretation and Conclusion:The results associated with the clinical observations suggest that diabetes can produce morphological and functional alterations in the oral epithelial cells, detectable by microscopic and cytomorphometric analysis using exfoliative cytology, which can be used in the diagnosis of the disease.

Detection of Cytomorphological Changes in Buccal Mucosal Cells of Type 2 Diabetic Patients Using Oral Exfoliative Cytology

“…Due to this epithelial cells show cellular adaption, depicted as nucleus hypertrophy with more DNA content as compared to normal cells. 22 In another study it was investigated on both the type 1 and type 2 diabetic patients and it was concluded that both the quantitative and qualitative cytomorphometric changes occurred in the oral mucosa. The type and pathophysiology of diabetes either type 1 or type 2 do not alter the effect on these cytomorphometric changes.…”

Assessment Of Oral Mucosal Epithelium In Type 2 Diabetic Patients Using Exfoliative Cytology: A Preliminary Study

“…As per a study conducted by Sankhla et al (2014), diabetes has an impact on the morphology of oral mucosa, potentially resulting in compromised tissue repair and retardation of tissue growth. The use of cytomorphometric analysis on cells obtained from diabetic patients holds promise as a non-invasive diagnostic tool.…”

Impact of preterm birth on the cellular characteristics of neonatal buccal cells

“…The buccal smear is a simple test in which mucosal cells are taken from the cheek, and these cells can be used for the investigation of the cellular effects of risk factors including bacterial, fungal, and viral infections, hormonal changes, immune system changes, diabetes mellitus and iron deficiency anaemia, neoplasms, radiotherapy, chemotherapy, alcohol and smoking, as well as genetic testing 3‐11 . We postulated that the evaluation of buccal smears might be a suitable approach for investigating of the impact of prematurity on neonates.…”