RESUMO
Background: In the country like India where oral cancer with its associated tobacco chewing habit exists in epidemic proportions, constitutes a major public health hazard. The high percentage of oral cancer if not preventable is curable only if detected in its early stage which require large scale screening of the population at risk carried out repeatedly from time to time. Exfoliative cytology plays important role in this. Aim: To study age and sex wise incidence of oral lesion, to study the clinical presentations, to study the role of tobacco chewing, gutkha, pan with areca nut and smoking in benign, premalignant and malignant lesions of oral cavity, to study the cytomorphological changes in oral cavity of different clinico- pathological lesions of chronic tobacco users, to corelate oral cytology with histopathology where ever possible. Materials and methods: A prospective study was carried out in total 135 chronic tobacco users. Patients above 15 years age who presented with oral lesion and with history of tobacco use in any form for more than 1 year were included in the study. Samples were obtained by scrape method using wooden spatula. All the smears were stained by Papanicolaou stain. Results: In the present study of 135 chronic tobacco users 73.33% were male and 26.67% were females. Male to female ratio was 2.75:1. Maximum 34.07% chronic tobacco users were in the age group of 31-40 year.30 cases of oral submucous fibrosis, 5 cases of leukoplakia and 59 cases of clinically suspected malignancy seen. Most common presenting symptom were ulceration in oral cavity in 51.11%. Commonest site of lesion was buccal mucosa in 56.30% cases. Cytological examination of smear showed dysplasia in 58.52% cases, smears positive / suspicious for malignancy in 37.04% cases and inflammatory smears in 3.70% cases. Clinically suspected malignant lesions were seen maximum (40 cases) in age group of 41-60 years which were using tobacco+lime, kharra, gutkha and tobacco smoking as habits. Incidence of malignancy was seen increasing with increased Shweta P. Bijwe, Arun P. Bakshi. Cytodiagnosis of oral lesions in chronic tobacco users. IAIM, 2018; 5(1): 17-27. Page 18 duration and frequency of tobacco use. Maximum 24 cases of malignancy (40.68%) were seen with use of tobacco for more than 25 years, affecting males commonly. Squamous cell carcinoma was the only histological type seen in all the cases. Percentage accuracy of cytologic diagnosis in oral cancer when compared with histopathological diagnosis was 84.75%. Conclusion: Cytology is a reliable method for diagnosis of oral cancer but histological examination remains the gold standard.
RESUMO
Identificar las características de la infección por VPH en la cavidad bucal asociada a la infección por VPH genital. En el Servicio de Ginecología Maternidad "Concepción Palacios". Caracas. Se estudiaron 60 pacientes con diagnóstico histológico de VPH genital a quienes se les realizó oroscopia, citología bucal y determinación viral por reacción en cadena de polimerasa (PCR) en boca y cérvix. Se aisló el genotipo viral en la cavidad bucal en 48,33 por ciento de las pacientes (29 / 60). Hubo concordancia entre la infección genital y bucal en 44,20 por ciento de los casos. Los genotipos aislados más frecuentes fueron el 6 (71,43 por ciento) y el 11 (22,86 por ciento), solos o en combinación; solo hubo un caso con genotipo 16 (2,86 por ciento). La concordancia entre el genotipo genital y bucal fue de 10,45 por ciento (P=0,1547), sin embargo, cuando el genotipo aislado fue 6 la concordancia fue de 75,86 por ciento. La citología de la cavidad bucal tuvo una sensibilidad de 3,5 por ciento y una especificidad de 93,6 por ciento. La oroscopia tuvo una sensiblidad de 27,6 por ciento y una especificidad de 74,2 por ciento. Es frecuente la asociación entre infección por VPH genital y bucal. Tanto la citología exfoliativa de la boca como la oroscopia, son métodos diagnósticos poco sensibles y específicos.
To describe the characteristics of HPV infection in the oral cavity associated with genital HPV infection. Service of Ginecology of the Maternidad "Concepcion Palacios". Caracas. 60 patients with histological diagnosis of genital HPV were studied with oroscopy, oral cytology and viral determination with polymerase chain reaction (PCR) in the mouth and in the cervix. Viral genotype was isolated in the oral cavity in 48.33 percent of patients (29/60). There was concordance between genital and oral infection in 44.20 percent of cases. Frequently isolated genotypes were 6 (71.43 percent) and 11 (22.86 percent), alone or in combination, there was only one case with genotype 16 (2.86 percent). The concordance between genital and oral genotype was 10.45 percent (p = 0.1547), but when isolated genotype was 6, the agreement was 75.86 percent. The cytology of the oral cavity had a sensitivity of 3.5 percent and a specificity of 93.6 percent. The oroscopy sensitivity was 27.6 percent and the specificity was 74.2 percent. It is often an association between genital and oral HPV infection. Both exfoliative cytology of the mouth and the oroscopy have low sensitivity and specificity as diagnostic methods.