Oral epithelial atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, peppers and hot meals, using the AgNOR and Papanicolaou staining techniques

Abstract

To evaluate cytological atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, hot meals, and peppers using the AgNOR and Papanicolaou methods. A total of 180 individuals were evaluated, of which 60 were smokers, 34 were alcohol users, 52 were habitual peppers and hot meal (exposed) consumers, 24 were non-exposed, and 10 were patients with Oral Squamous Cell Carcinoma (OSCC), as an internal control. Cytological materials were obtained by brushing of buccal mucosa, on the border of the tongue and on the floor of the mouth, and participants underwent the Papanicolaou test for cytological changes and AgNOR staining for evaluation of the mean number of AgNOR dots per nucleus. SPSS program was used to perform the Pearson chi-square test. The 95% confidence level, Odds Ratio (OR), and the 95% Confidence Intervals (CI) were used. The features of cytological atypia were verified among 10 individuals, including 5 smokers, 2 alcohol users, 2 hot meals and peppers consumers, and one non-exposed. For atypia among tobacco smokers, the adjusted Odds Ratio (OR) and the 95% CI were found to be 2 (0.246-16.24). Increased keratinization was detected among 27 (45%) of the smokers (P < 0.0001), 17 (32.7%) of the pepper and hot meals consumers (P < 0.005), 4 (11.8%) of the alcohol consumers, and among 2 (3.7%) of the non-exposed group. Statistical analyses revealed a greater mean number of AgNORs per nucleus in smokers (3.68) followed by (2.82) alcohol consumers, compared to the habitual peppers and hot meal consumers (2.28) and the non-exposed group (2.00). What's more, 80% of the smears with cytological atypia were identified with 6 +/- 2 AgNOR mean count. The increase of the variables suggests that the evaluation of epithelial atypical changes in individuals exposed to smoking and alcohol carcinogens may be a useful screening tool. While hot meals and peppers did not seem to be a risk for oral mucosal proliferation, they increased the potency of keratinization and infection.

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“…Several reports have indicated that tobacco smoking can result in oral precancerous lesions, which can gradually progress into oral cancer, even in the absence of clinical indicators. In the evolution of malignant progression, changes happen at the cellular level before clinical changes become evident [20,21]. Thus, detection of high-risk precancerous oral lesions and intervention is a major key toward reducing the incidence, prevalence, death and cost of treatment associated with oral cancer.…”

“…Thus, detection of high-risk precancerous oral lesions and intervention is a major key toward reducing the incidence, prevalence, death and cost of treatment associated with oral cancer. Early alterations in the oral mucosa can be identified oral exfoliative cytology through screening of population at risk [15][16][17][18][19][20][21][22][23]. Oral Exfoliative Cytology is well accepted by patients and it is a practical diagnostic and screening method for diagnosis and early detection of oral mucosal lesions [24].…”

Molecular Screening for PTEN Gene Mutation Among Cigarette Smokers and Assessment of Knowledge of the Link Between Tobacco Use, and Cancer Among Saudi Population.

“…The major etiologic factors in the development of oral cancer is tobacco use and alcohol consumption. 10,19 The identification of prognostic and predictive markers is clinically essential, since oral cancer is a group of heterogenous diseases with different biological and clinical features. The current study point out the utility of PTEN in the genesis of carcinoma of oral.…”

Exfoliative Cytological Assessment of Apparently Normal Buccal Mucosa among Quid Chewers Using Argyrophilic Nucleolar Organizer Region Counts and Papanicolaou Staining

“…Its potential in identifying precancerous and cancerous lesions in the buccal mucosa smears has also been explored [15]. Ever since tobacco has been identified as an etiologic factor for oral cancer, numerous studies have also been done on tobacco smokers’ mucosa using AgNORs to evaluate early changes in their mucosa showing positive results [16,17,18,19,20,21,22,23,24,25,26,27]. …”

“…Though several studies exist using PAP and AgNOR together among tobacco smokers [17,20,22,24], there is none that has evaluated these parameters among quid chewers. The purpose of the present study is to assess cellular proliferation levels and cytological atypia in quid chewers and non-chewers using AgNOR and PAP techniques, respectively.…”