Assessment of Cytomorphometric Features of Oral Squames from Buccal Mucosa of Tobacco Users using Oral Brush Biopsy: An Exfoliative Cytological Study.

Background: Tobacco comprises of one of the most common addiction in the society. All the forms of the tobacco are harmful, causing alterations in the cellular parameters of the oral mucosal cells. A number of techniques and methods are available along with chair side examination for supplementing the diagnosis of tobacco induced premalignant lesions. Exfoliative cytology is one such technique, which is non-invasive and can be used for mass screening. Therefore, we evaluated the cytological and cytomorphometric changes in the oral squames using brush biopsy from buccal mucosa of tobacco users. Methods: A total of 300 patients with age group of 25 to 60 years were included in the study. Detailed history of the patients were taken to known the method (smoking, smokeless or both) and frequency of tobacco intake. Scrapings from the buccal mucosal scrape were obtained, smeared on slides and were subsequently stained with Hematoxylin and Eosin staining. Observation and analyses of the smears was done under microscope followed by analysis in the computer using software Dewinter Biowizard version 3.0. various cellular parameters were assessed and compared in between different groups. Patients were divided into two major groups- Habituers and Nonhabituers. The habituers were again divided into: Tobacco smokers, Tobacco chewers and patients having combined habit. Independent-Samples T Test and One-Way ANOVA were used to assess the level of significance. Results: Significant results were obtained while comparing nuclear parameter, cellular area, cellular perimeter, cell contour and nucleo-cytoplasmic ratio in between lesional group and tobacco smoking group. While comparing between tobacco smoking group and Non habituers group, significant results were obtained in all the parameters except for cell contour and N/C ratio. Significant results were obtained while comparing between lesions and combined habit groups. While comparing between habituers and non- habituers group, except for cell contour significant results were obtained in all other cellular parameters. Conclusion: Early changes detection in clinically normal oral mucosa of tobacco users is possible by using non-invasive, painless procedures like oral brush biopsy and cytomorphometry. Further studies recommended.