Author/Authors :
Verma، Renuka نويسنده Dept. of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana , , Singh، Anil Kumar نويسنده , , Badni، Manjunath نويسنده Sardar Patel Institute of Dental and Medical Sciences, Lucknow , , Chandra، Akhilesh نويسنده Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi , , Gupta، Shalini نويسنده King George’s Medical University, , , Verma، Ruchita نويسنده Shree Bankey Bihari Dental College & Research Centre, Ghaziabad, Uttar Pradesh, ,
Abstract :
Background: Many oral squamous cell carcinomas (OSCCs) arise within regions that previously
had premalignant lesion. Early diagnosis and prompt treatment of premalignant lesions offers the
best hope of improving the prognosis in patients with OSCC. Exfoliative cytology is a simple and
non-invasive diagnostic technique that could be used for early detection of oral premalignant
and malignant lesions. This study was undertaken to evaluate the quantitative changes in nuclear
area (NA), cytoplasmic area (CA) and nuclear-to-cytoplasmic ratio (NA/CA) in cytological
buccal smears of oral leukoplakia with dysplasia (OLD) and OSCC patients while comparing
with normal healthy mucosa.
Materials and Methods: A quantitative study was conducted over 90 subjects including
30 cases each of OLD, OSCC and clinically normal oral mucosa. The smears obtained
were stained with Papanicolaou (PAP) stain and cytomorphological assessment of the
keratinocytes was carried out. The statistical tools included arithmetic mean, standard deviation,
Chi-square test, analysis of variance, Tukey multiple comparison. P < 0.001 was considered
as signifi cant.
Results: The mean NA of keratinocytes in the normal mucosa was 65.47 ± 4.77 ?m2 while for
OLD it was 107.97 ± 5.44 ?m2 and 139.02 ± 8.10 ?m2 for that of OSCC. The differences show a
statistically signifi cant increment in NA (P < 0.001). There was signifi cant reduction (P < 0.001) in
the CA of keratinocytes from OSCC when compared with those from smears of OLD and normal
mucosa with the values of 1535.80 ± 79.38 ?m2, 1078.51 ± 56.65 ?m2 and 769.70 ± 38.77 ?m2
respectively. The NA/CA ratio in the smears from normal oral mucosa, OLD and OSCC showed a
mean value of 0.043 ± 0.004, 0.100 ± 0.008, 0.181 ± 0.015 respectively with a signifi cant difference
among the groups (P < 0.001).
Conclusion: Evaluation of nuclear and CA of keratinocytes by cytomorphometry can serve as
a useful adjunct in the diagnosis and prognosis of a dysplastic lesion which may lead to OSCC.
