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

Abstract

Objective: Quid chewing is associated with an increased risk of oral cancer. This study aims to analyze argyrophilic nucleolar organizer region (AgNOR) counts along with Papanicolaou (PAP) staining in exfoliative smears of quid chewers and non-chewers to correlate quid chewing habits with possible early cytological changes in apparently normal buccal mucosa. Study Design: Exfoliative smears were obtained from normal buccal mucosa of 30 male quid chewers and non-chewers. The smears were stained using the AgNOR silver staining technique to evaluate the proliferative activity and PAP for cytological appearance. Results: Statistically higher AgNOR counts were observed in chewers as compared to non-chewers. The difference in the mean percentage of nuclei having ≥5 AgNORs in both groups was statistically significant (p = 0.001). In chewers, PAP showed 77% with class I and the remaining 23% were class II, while the non-chewers showed only class I cytology. AgNOR counts between chewers and non-chewers having class I cytological appearance demonstrated a greater mean AgNOR count in chewers (p = 0.0001). Conclusion: Quid chewing seems to have a definite role in promoting proliferative activity of apparently normal buccal mucosal cells. Exfoliative cytological assessment of a combination of AgNOR counts and PAP has the potential for prediction of early quid-associated cellular changes before the appearance of clinical premalignant and malignant lesions.

Comparative study using Papanicolaou stain and silver-stained nucleolar organizer region counts in exfoliative smear of oral mucosa in bidi smokers and nonsmokers

“…The effect of smoking was demonstrated by a significantly larger number of AgNORs per nucleus in mucosal cells of the buccal mucosa, indicating a higher proliferative activity of these cells. [ 20 ] Sood et al . observed that AgNOR is useful in estimating nuclear proliferative activity.…”

Exfoliative Cytology in the Oral Mucosa of Patients with Fanconi Anaemia: A Morphometric Approach

“…24 AgNORs are a valuable parameter of cell kinetics that are associated with the rapidity of cell duplication, which may characterise dysplasia. 12,14,19 The quantitative analysis of AgNOR allows us to evaluate the level of cellular proliferation and follow up the lesions with a susceptibility of malignancy. However, this could not be confirmed because nucleolar quantitative changes were not observed in this study.…”

“…A value of one AgNOR was assigned during analysis when the assemblage of blackened points could not be viewed as AgNOR. 18,19 Statistical tests were performed with SPSS for Windows 13.0 (SPSS Inc., Chicago, IL, USA). Significant statistical differences between groups were examined using Student's t-test (NA, CA, NA/CA, and AgNORs), p< 0.05.…”

Detection of cytological changes in oral mucosa among users of smokeless tobacco (shamma) in the KSA

“…For instance, Ahmed and Mahgoob, investigated the impact of toombak on the aetiology of oral cancer using Papanicolaou staining. Likewise, several studies have detected micronuclei in exfoliated buccal mucosal cells among ST users and smokers and have evaluated cytological changes among betel quid chewers using this method . A cytomorphometric study by Hashemipour et al among smokers and nonsmokers of opium found a decreased cellular diameter accompanied by an increased nuclear diameter and an increased ratio of nucleus/cytoplasm in smear samples from opium addicts and smokers compared to nonsmokers.…”