Morphologic and cytomorphometric analysis of exfoliated buccal mucosal cells in diabetes patients

Comparative Analysis of Cytomorphology in Adolescent and Geriatric Patients: A Cross-Sectional Study

Background Exfoliation of the surface cells of the normal epithelium occurs as a result of physiological turnover. Epithelial cells are constantly renewed, and they are exfoliated or shed as they migrate from the basal layer to the uppermost layer of the epithelium. Oral exfoliative cytology involves the collection and microscopic evaluation of these shed cells or scraped epithelial cells, quantitatively and qualitatively. The objective of the present study was to analyze and compare the cytomorphometric features like cellular area, nuclear area, and nuclear-cytoplasmic ratio from buccal mucosal smears of adolescent and geriatric patients. This study highlights the changes in cell morphology in different age groups (adolescent and pediatric), which could be attributed to hormonal, habitual, and aging factors.  Material and methods Buccal smear sample was collected from a total of 60 individuals belonging to the age groups of 11-19 years and above 60 years. The smears were stained with H&E and PAP (Papanicolaou) stain. Photomicrographs were taken in 40x, and measurements were calculated using ImageJ software (National Institutes of Health, Bethesda, Maryland, United States). Cellular size, nuclear size, and nucleo-cytoplasmic ratio were analyzed and compared between the two age groups using independent t-tests using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, New York, United States). Results A significant difference was observed in the cellular area and nuclear area between the two age groups with a p-value of 0.00. No significant findings were present in the nucleo-cytoplasmic area of the two age groups. Conclusion Cytomorphometric analysis has shown that there were variations in the cytoplasmic and nuclear areas among different age groups.

Cytomorphometric Analysis of Exfoliated Buccal Mucosal Cells and DNA Repair Proficiency in Peripheral Lymphocytes in Type 1 Diabetes Mellitus

The aim of this study was to analyze the cytomorphometric changes in the buccal mucosal smears and to correlate the cytomorphometric findings and glycosylated hemoglobin (HbA1c) in type 1 diabetic (T1D) patients. In addition, DNA repair proficiency in peripheral lymphocytes of T1D patients was evaluated. Smears from the clinically normal buccal mucosa of 46 healthy subjects as controls and randomly selected 45 T1D patients, were stained using the Papanicolaou method, and the mean values (μm2) of nuclear area (NA), cytoplasmic area (CA), and cytoplasmic: nucleus ratio (CNR) were obtained for each patient. DNA damage in diabetics and control subjects was tested on peripheral blood samples using an in vitro mutagen sensitivity assay. Statistical analysis included Student's t-test, one-way ANOVA, and Pearson's correlation test to correlate cytomorphometric changes with HbA1c levels in both T1D and healthy control groups. The mean NA and CA values were higher in T1D while the mean CNR was found to be higher in the healthy control group. Statistical significance between the two groups was found only for the mean NA (P < 0.001) and mean CNR values (P < 0.001). A significant correlation was seen between HbA1c and CNR in both the T1D group (P = 0.015) and the healthy control group (P = 0.02). Significant differences were noted between the T1D and control subjects with regard to the frequency of damaged cells and DNA repair proficiency (P < 0.05). Significant cytomorphometric alterations were detected in the buccal mucosal cells of diabetic patients, which may aid in the early detection of diabetes or predict the risk for future disease complications among T1D patients.

Comparative Evaluation of Buccal Exfoliated Cells in Individuals with Diabetes Mellitus and Healthy Controls: A Cytomorphometric Analysis

Background

Diabetes mellitus is the third most frequent cause of mortality and morbidity worldwide. Patients with diabetes exhibit a variety of oral symptoms, and hence the early detection of this condition can be addressed by a dentist.

Aim

The current study aimed to study the cytomorphometric alterations of buccal exfoliated cells in individuals with type II diabetes mellitus.

Methodology

The study included thirty diabetics and thirty healthy controls. The smears were obtained from the buccal mucosa and stained with Papanicolaou stain and hematoxylin and eosin stain. The presence of inflammatory cells, microbial carriage, nuclear enlargement, and perinuclear halo and binucleation were examined on the slides. Cellular and nuclear parameters were quantitatively measured using Image J software. Statistical analysis was done using SPSS software, and the Student's t-test was employed.

Results

No inflammatory cells or microbes were observed in Group I individuals; however, the perinuclear halo was observed in 16.6% and binucleated cells in 3.3% of the controls. Inflammatory cells, consisting mainly of neutrophils and lymphocytes were seen in 40%, microbial carriage in 26.6%, perinuclear halo in 73.3%, and binucleated cells in 36.6% of the diabetic patients. The mean nuclear diameter, area, and nuclear-cytoplasmic ratio were significantly high in diabetic patients when compared to healthy controls.

Conclusion

Oral exfoliated mucosal cells of patients with diabetes mellitus exhibit distinct cytomorphometric alterations such as increased nuclear diameter, nuclear area, and nuclear-cytoplasmic ratio.

Cytomorphometric Assessment of Buccal Mucosa Cells and Blood Sugar Status in Diabetic Patients in Zahedan (2019)

Background: Diabetes mellitus is one of the major global health threats. Diabetes can cause adverse cytopathological changes in cells and predispose them to pathological lesions. The present study aimed to investigate the cytopathological changes of oral mucosal cells in type 1 and 2 diabetes patients and its relationship with blood sugar status. Methods: This study descriptive-analytical was performed on 40 type-1 diabetes patients, 40 type-2 diabetic patients, and 20 non-diabetic individuals (control group) with simple sampling in Zahedan (2019). Their buccal mucosa was sampled by a cytobrush and the microscope slides were prepared with Papanicolaou staining. The nuclear and cytoplasmic area and cytoplasmic-nuclear ratio were calculated. Furthermore, the relationship of hemoglobin A1C and fasting blood sugar with these parameters were also examined. Data was analyzed with one-way-ANOVA, Kruskal-Wallis, Post Hoc Tukey, Mann-Whitney, Pearson correlation and Spearman correlation tests. In this regard, the statistical software SPSS (version 21) was used and a p-value <0.05 was considered statistically significant. Results: Based on the findings, only the nuclear area was significantly larger in type 1 and type 2 diabetes patients, compared to the control group (p<0.001 and p=0.010), respectively. Moreover, the comparison of cytomorphometric changes between type 1 and type 2 diabetes patients did not show a significant difference. In addition, the hemoglobin A1C levels were merely associated with the cytoplasmic area in type 2 diabetes patients (p=0.011), while fasting blood sugar levels were not associated with any of the parameters in type 1 and type 2 diabetes patients (p>0.050). Conclusion: Diabetes, as an independent factor, can cause cytomorphometric changes in the buccal mucosal cells of type 1 and type 2 diabetes patients. It seems that the type of diabetes does not affect these changes. hemoglobin A1C levels were correlated with cytoplasmic area in type 2 diabetes patients.

Effect of Inhalational Therapy on Buccal Mucosal Cells in Asthmatic Patients: A Cytological Study

OBJECTIVE

Inhalational drugs used in treating asthma have several side effects including those on oral tissues. We therefore designed a study to analyze the effects of inhalational drugs on the buccal mucosal cells of the oral cavity.

METHODS

Smears were obtained from clinically normal buccal mucosa of 20 randomly selected asthmatic patients who had been under inhalational therapy for at least 6 months. The Papanicolaou-stained smears were then analyzed for average nuclear area, average cytoplasmic area, and average nuclear area:cytoplasmic area ratio for each patient, and the values were compared with those of 10 healthy controls.

RESULTS

A statistically significant decrease in cytoplasmic area (P<0.001) was found in asthmatic patients compared to controls. A significant increase in mean nuclear area:cytoplasmic area ratio (P<0.001) was noted in asthmatic patients when compared to controls.

CONCLUSION

Prolonged use of inhalational drugs in patients diagnosed with asthma is associated with changes in oral epithelial cells. There is a need to assess whether these are the direct adverse effects of such drugs and whether they have any long-term impact on oral tissues.

Cytological intracellular glycogen evaluation using PAS and PAS-D stains to correlate plasma glucose in diabetics

Background

Oral cytology studies have claimed that cytoplasmic Periodic Acid Schiff (PAS) positivity in type-2 diabetics is due to glycogen content. But, it can also be due to mucin and glycoconjugates.

Aim

1. To confirm that cytoplasmic PAS positivity in type-2 diabetics is due to glycogen using diastase. 2. To know the effect of diabetes by determining the number of glycogen-containing cells in the smear. 3. To assess the impact of duration of diabetes based on PAS staining of cells. 4. To correlate between random blood glucose level and the number of PAS-positive cells.

Materials and Methods

Study population comprised 45 individuals with 30 type-2 diabetics as case group (Group I < 5 years duration; Group II > 5 years duration) and 15 healthy volunteers (age and gender-matched) as control. For all subjects, random blood glucose was estimated and two cytosmears were obtained. The smears were stained with PAS and PAS-diastase stains (PAS-D). Staining intensity was documented as score 1 (mild-to-moderate) and score 2 (moderate-to-intense) and data obtained were statistically analyzed in SPSS version 16.0.

Results

Mann-Whitney U test revealed that in diabetics cytoplasmic PAS positivity is because of glycogen (P < 0.05). There is an increase in the number of glycogen-containing cells (P < 0.05) in diabetics. The duration of diabetes had less impact on intracellular glycogen accumulation (P > 0.05). Spearman's correlation test revealed no significant correlation (P > 0.05) between random blood glucose and a number of PAS-positive cells.

Conclusion

PAS positivity is because of intracellular glycogen accumulation in type-2 diabetics. It can convey the glycaemic status of an individual in the recent past, thus a beneficial role in screening and therapeutic monitoring.

Periodontal health status and implication of periodic acid-Schiff diastase - a key in exfoliative cytology among diabetics mellitus patients: A case-control study

Objectives:

The objectives of the study are: (i) To determine if periodic acid–Schiff (PAS)-Diastase is an effective tool to diagnose DM noninvasively, (ii) to use three different types of staining procedures to identify the staining pattern over the exfoliated cells of normal and diabetic patients, (iii) to study the periodontal health status of DM and normal subjects.

Materials and Methods:

Basic questions regarding the demographic data were asked, following which community periodontal index (CPI) was recorded. Oral smears were collected from clinically normal buccal mucosa of 150 patients using wooden tongue spatulas. The subjects were asked to gargle their mouth with water and the wooden spatula was scraped at the site from buccal mucosa. The smears were spread evenly on a dry clean glass slide and fixed immediately with absolute ethyl alcohol. Three slides were prepared for each of the patients. PAS, PAS with diastase digestion, and Papanicolaou staining were performed and examined under a microscope.

Results:

Average CPI for study subjects was 3.2 and control subjects was 2.1. The average loss of attachment was 1.1 in the study group and 0.2 in the control group (P - 0.00) and the result are statistically highly significant. All the 150 cases (100%) were positive for PAS staining, while PAS-diastase (PAS-D) staining showed positivity only for normal subjects and was negative (100%) in the diabetic group (P - 0.00) and the result are statistically highly significant.

Conclusions:

Results of our study showed that exfoliative cytology of the oral cavity, when stained with PAS and PAS-D, can be used as an effective screening and diagnostic tool for DM patients.

Cytomorphological Study of Oral Exfoliated Cells in Type II Diabetes Mellitus Patients

Introduction

Diabetes mellitus (DM) is one of the most common endocrine metabolic disorders and its prevalence has been increasing worldwide. It is a third leading cause of mortality and morbidity in the world. Diabetes affects several organs including the oral cavity. The oral complications of uncontrolled DM can include xerostomia, infection, poor healing, increased incidence and severity of caries, candidiasis, gingivitis, periodontal disease, periapical abscesses, and burning mouth syndrome. Early diagnosis of the DM is an important aspect of health care. Exfoliative cytology is considered a moderate, straightforward, and noninvasive diagnostic marker for DM. The purpose of this study is to demonstrate cytologic changes of the exfoliated oral mucosal cells of diabetic patients using hematoxylin and eosin (H&E) staining technique to establish its role as diagnostic criteria.

Results

The frequency of micronuclei, enlarged nucleus, perinuclear halo, binucleation, cytoplasmic streaks, Candida, and inflammation were found to be statistically significant.

Conclusion

Clinical observations and results suggested morphologic and functional alterations in oral epithelial cells in diabetic patients, detectable by microscopic and cytomorphometric analysis using exfoliative cytology and can be used in diagnosis.

Clinical significance

The purpose of this study is to demonstrate cytologic changes of the exfoliated oral mucosal cells of diabetic patients using H&E staining technique to establish its role as diagnostic criteria.

How to cite this article

Srinivasan S, Priya NS, Rao K, Umadevi HS, Smitha T, Sheethal HS. Cytomorphological Study of Oral Exfoliated Cells in Type II Diabetes Mellitus Patients. J Health Sci Res 2017;8(1):38-41.

Cytomorphometric analysis of gingival epithelium and buccal mucosa cells in type 2 diabetes mellitus patients

BACKGROUND

The global prevalence of type 2 diabetes continues to rise. Interest has been increasing recently in noninvasive diagnostic procedure. Hence, an attempt has been made by the present study to analyze the changes in cytomorphometry in exfoliated buccal and gingival mucosa cells in type 2 diabetic patients.

AIM

The aim of this study was to analyze the cytomorphometric changes in exfoliated cells of gingiva and buccal mucosa as an adjunct to diagnosis of diabetes.

MATERIALS AND METHODS

In the present study, fifty known type 2 diabetic patients were taken as study group, and the control group was comprised of fifty healthy individuals. Smear was prepared from buccal mucosa and gingival epithelium of both study and control groups and was stained by rapid Papanicolaou (Pap) stain. Stained smears were subjected to cytomorphometric analysis using Lynx Biolux (Lawrence and Mayo) image analysis software. In each Pap smear, 100 cells were evaluated for nuclear area (NA), cytoplasmic area (CA) and cytoplasm to nuclear ratio (CNR).

RESULTS

Mean NA was significantly higher (P < 0.05) in study group whereas mean CA did not exhibit any statistically significant difference (P > 0.05). The mean CNR was significantly lower in the study group (P < 0.05).

CONCLUSION

This study contributes to the general understanding of the alterations in the cellular pattern of buccal and gingival mucosa cells in diabetic patients and can be used as an additional tool to aid in the evaluation of oral mucosal alterations in diabetes mellitus.

Efficacy of oral exfoliative cytology in diabetes mellitus patients: a light microscopic and confocal microscopic study

AIM

Diabetes mellitus (DM) has become a global problem. By monitoring the health status of these individuals, diabetic complications can be prevented. We aimed to analyze alterations in the morphology and cytomorphometry of buccal epithelial cells of type 2 DM patients using oral exfoliative cytology technique and determine its importance in public health screening, diagnosis and monitoring of diabetes mellitus.

MATERIALS AND METHODS

The study was carried out in 100 type 2 DM patients and 30 healthy individuals. Smears were taken from the right buccal mucosa and stained by the Papanicolaou technique. Staining with Acridine orange was carried out to view qualitative changes with confocal laser scanning microscope (LSM-510 Meta). The cytomorphometry was evaluated using IMAGE PRO PLUS 5.5 software with Evolution LC camera. All findings were statistically analyzed.

RESULTS

The results showed that with increase in fasting plasma glucose levels, there is significant increase in nuclear area, decrease in cytoplasmic area, and increase in nuclear cytoplasmic ratio (p < 0.05) when compared to the control group. Various qualitative changes were noted, such as cell degeneration, micronuclei, binucleation, intracytoplasmic inclusion, candida and keratinization.

CONCLUSION

In the present study, we found significant alterations in the cytomorphometry and cytomorphology of buccal epithelial cells of type 2 DM patients. This study supports and extends the view that these cellular changes can alert the clinician to the possibility of diabetes and aid in monitoring of diabetes throughout the lifetime of the patient.

Evaluation of Pre-Malignant and Malignant Lesions in Cervico Vaginal (PAP) Smears by Nuclear Morphometry

BACKGROUND

Cervical cancer is the second most common cancer occurring among women worldwide, with almost half a million new cases each year. Normal cells gradually transform to form cancer cells through several stages. So, the changes occurring during the transformational stages need to be assessed.

AIM

Our aim was to study various nuclear parameters useful in evaluating pre-malignant and malignant cervico-vaginal pap smears.

MATERIALS AND METHODS

Bethesda System was used to categorize cervical pap smears into premalignant and malignant lesions. Nuclear parameters were calculated using J 1.44C morphometric software. Several nuclear size parameters were analysed.

RESULTS

The nuclear area, perimeter, diameter were found to be statistically significant (p<0.05) parameters in differentiating premalignant from malignant cervical smears.

CONCLUSION

Nuclear morphometry was thus a useful objective tool in differentiating premalignant from malignant cervical smears.

Quality assessment of saliva bank samples

INTRODUCTION

Biospecimens, such as urine, blood, saliva, tissue, cells, DNA, RNA, and protein, are biological material to be stored in a biorepository. They constitute critical resources of molecular data for basic and translational research integrated with diagnostic, therapeutics, and prevention of human diseases. The reliability of the molecular data is dependent on the quality and the consistency of the biospecimen being analyzed. The potential of human saliva as a valuable diagnostic fluid for oral and systemic conditions is being increasingly recognized. The aim of this study is to determine the molecular quality of unstimulated whole saliva (UWS) samples stored over a period of 1 to 5 years.

MATERIALS AND METHODS

UWS samples collected between 2006 and 2010 (20/year) and stored at -80°C were assessed for molecular integrity. The study was approved by the institutional review board of the Indiana University Purdue University at Indianapolis. Qualitative and quantitative measurements of salivary proteins were determined by gel electrophoresis and spectrophotometry. The salivary nucleic acid content was determined by the Nanodrop method and genetic analysis. The nature of the cellular sediment in the UWS was determined by amplification of specific gene.

RESULTS

No significant differences were observed in the amount of proteins, nucleic acid, or in the number of viable cells in the UWS samples stored for 1 to 5 years.

CONCLUSION

Archived UWS samples could function as excellent biospecimen resources for measurement of protein, DNA, and RNA analytes, and act as an efficient source for human epithelial cells.

Nuclear morphometric and morphological analysis of exfoliated buccal and tongue dorsum cells in type-1 diabetic patients

Background:

Diabetes mellitus type 1 that results from immunologically mediated damage to the β-cells in the pancreas. Diabetes mellitus is characterized by recurrent or persistent hyperglycemia. Hyperglycemia can be associated with salivary gland dysfunction and alterations in the oral epithelial cells.

Aim:

The aim of this study was to evaluate the qualitative and quantitative changes in buccal and tongue dorsum epithelial cells using an exfoliative cytology method in type 1 diabetic patients.

Materials and Methods:

We performed light microscopic analysis of the buccal and tongue dorsum smears in thirty type 1 diabetic patients and thirty healthy individuals. The oral smears were stained using Papanicolaou method for cytological examination and nuclear morphometric analysis. In each case, the mean nuclear area, perimeter, length, breadth, and roundness factor were evaluated in each smear using the image analysis software (Q Win, Leica™).

Results:

The nuclear area, length, breadth, and perimeters were significantly higher in the diabetic group from tongue dorsum smear than that of the control group (P < 0.05). In the cytological examination, karyorrhexis-karyolysis-karyopyknosis, binucleation, nuclear membrane irregularity, cytoplasmic polymorphism, perinuclear halo were observed in oral smears with type 1 diabetic patients. Binucleation (P = 0.002) and nuclear membrane irregularity (P = 0.024) were significantly more common in buccal smears of diabetic group. Furthermore, the sensitivity of buccal mucosa was significantly higher in the diabetic group (P = 0.006).

Conclusion:

The light microscopic and nuclear morphometric study indicates that type 1 diabetes can produce morphological and nuclear morphometric changes in the oral mucosa that are noticeable with exfoliative cytology.

Exfoliative cytology of buccal squames: A quantitative cytomorphometric analysis of patients with diabetes

BACKGROUND

Diabetes is a third leading cause of mortality and morbidity in the world. Diabetes is one of the most common endocrine metabolic disorders and its prevalence has been increasing worldwide. Oral exfoliative cytology may be a more appropriate adjunctive diagnostic tool in conditions like diabetes mellitus, where the invasive techniques lose viability.

AIMS

The purpose of this study is to analyze the cytomorphometric changes in the exfoliated cells of the oral mucosa, as an adjunct to the diagnosis of diabetes.

MATERIALS AND METHODS

Smears were taken from the buccal mucosa of 30 diabetes patients (study group) and 30 healthy individuals (control group). All the smears were stained with rapid Papanicolaou stain (PAP). In the PAP smears, the nuclear area (NA), cytoplasmic area (CA), and cytoplasmic-to-nuclear ratio (CNR) were evaluated for 50 cells in each smear, using the Image Analysis Software (Magnus Pro™) and research microscope (Lawrence and Mayo™).

RESULTS

The results showed that the mean NA was significantly higher (P < 0.001) in the study group, whereas, the mean CA did not exhibit a statistically significant difference (P > 0.001). The mean CNR was significantly lower in the study group (P < 0.001).

INTERPRETATION AND CONCLUSION

The results associated with the clinical observations suggest that diabetes can produce morphological and functional alterations in the oral epithelial cells, detectable by microscopic and cytomorphometric analysis using exfoliative cytology, which can be used in the diagnosis of the disease.

Role of fine needle aspiration, imprint and scrape cytology in the evaluation of intraoral lesions

Aim:

The primary goal of our study was to evaluate the value and accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of various intraoral lesions and to correlate the cytological diagnosis with final histopathological findings.

Materials and Methods:

Fine needle aspiration was performed in 229 patients presented with different lesions of the oral cavity at our institution. Cytological findings were then compared with final histopathological diagnosis.

Results:

With a male to female ratio of 1.79:1, 229 patients presented with different lesions of the oral cavity were aspirated. Histopathological correlation was available in 86.9% of cases while inadequate material was obtained in 13.1% cases. The diagnostic accuracy of fine needle aspiration in diagnosing benign, pre-malignant and malignant lesions were 95.8%, 84.6% and 97% respectively. Overall the diagnostic accuracy of FNAC in diagnosing intraoral lesions was 94.9% with sensitivity and specificity of 93.2% and 96.8% respectively.

Conclusion:

FNAC of intraoral lesion is recommended as a valuable procedure for the initial evaluation of all intraoral lesions as it is simple, inexpensive, convenient and comfortable to the patient. Moreover, it can offer a rapid and accurate diagnosis for further management of the patient.

Hormonal changes in exfoliated normal buccal mucosal cells

AIMS

The present study was undertaken as a baseline study to evaluate the nuclear diameter (ND), cell diameter (CD) and nuclear-cytoplasmic ratio (N:C) and their variation with age in normal buccal smears of female subjects.

MATERIALS AND METHODS

Buccal smears were collected from 400 apparently healthy individuals. After fixation in 95% alcohol, the smears were stained using the standard Papanicolaou laboratory procedure. The CD and ND were measured using a stage micrometer and an ocular micrometer. Statistical analysis of the data was performed using the one-way analysis of variance to evaluate the difference in the ND, CD and N:C with age in females. Multiple range tests by Tukey-honestly significant difference procedure were performed to evaluate the significance between various age groups.

RESULTS

The results showed an increase in ND and CD from the 5-10 age groups to 15-35 age groups. In the 15-35 age groups, there was a decline in ND and CD when comparing the first and the second half of the menstrual cycle, but the difference was not significant. There was further decline in ND and CD in the 45-60 age groups. Variations were also seen in ratio N: C. Pattern of exfoliation also varied in each age group.

CONCLUSION

Age-related alterations are observed in buccal smears.

Evaluation of cytological alterations of oral mucosa in smokers and waterpipe users

OBJECTIVE

Oral mucosal epithelia of smokers and waterpipe users are more susceptible to malignant alterations. The aim of this study was morphometric evaluation of the effects of using waterpipe on normal oral mucosa.

MATERIALS AND METHODS

IN A CROSS SECTIONAL STUDY, CYTOLOGIC SMEAR SAMPLES FROM THE FOLLOWING THREE DIFFERENT AREAS: buccal mucosa, lateral surface of the tongue, and floor of the mouth (right) were taken from 40 smokers, 40 waterpipe users, and 40 normal individuals. They were then stained using Papanicolaou staining technique. Quantitative cytologic alterations such as nuclear and cytoplasmic size, nuclear-cytoplasmic (N/C) ratio, Feret ratio (FR), percent of karriorhexis, vacuolization of cytoplasm, two or multilobed nuclei, inflammation, and candida were evaluated. Quantitative evaluation was performed using MoticPlus 2 software, and 50 cells in each slide were studied. Practitioners were matched with age and sex in three groups.

RESULTS

An increase in nuclear size, the N/C ratio, and F.R, while a decrease in cytoplasm size were observed in lateral surface of the tongue, buccal mucosa and floor of the mouth of smokers, waterpipe users and normal individuals, respectively (p≤0.001). No statistically significant differences were observed in percent of karriorhexis, vacuolization of cytoplasm, and two or multilobed nuclei in oral mucosa of smokers, waterpipe users (p=0.8), and normal individuals (p=0.9) in buccal mucosa, tongue, and mouth floor areas. However, the percentage of inflammation and candida in smokers (p<0.001) and waterpipe users (p=0.002) were higher than normal individuals.

CONCLUSION

Smoking and using waterpipe are effective in creating some quantitative cytometric alterations in oral mucosa; however, smoking shows greater effect in the cytometric alterations than using waterpipe. Role of cytology in screening and detection of oral mucosa malignancies in smokers and waterpipe users needs further studies.

Evaluation of oral mucosal epithelium in diabetic male patients by exfoliative cytology method

Background

The goal of present study is to examine comparatively the epithelium of oral mucosa in persons with diabetes types I and II and the healthy persons by cytomorphometric method.

Methods

Cytology smear was prepared from oral mucosa epithelium in 24 persons with diabetes and 30 healthy persons were stained by papanicolao method. Its before, from patients were requested acquiring written. The quantitative cytomorphometric characteristics were measured in each group by motic plus 2 software. Also, the qualitative evaluation of cytology slides are performed in three groups.

Results

There were decrease in the nuclear and cytoplasmic size, (P < 0.001) and increase in the ratio of nuclear to cytoplasm size in buccal mucosal areas (P = 0.001) and tongue (P = 0.011) of diabetic persons compared to the healthy persons. There was no significantly statistical difference in diabetic persons types I and II in buccal mucosal area (P = 0.15) and tongue (P = 0.86) in quantitative characteristics of cytomoerphometry. In nuclear and cytoplasm size, there was a significant statistical difference in persons with diabetes type I and persons of control I and persons with diabetes type II and persons of control II in buccal mucosa and the tongue (P < 0.001). Bilobed or multi-lobed nuleous, karyorrhexis and vacuolization of cytoplasm were more in diabetic persons compared to the healthy ones (P < 0.001).

Conclusion

Diabetes are effective in creating some quantitative and qualitative cytometric alterations in the oral mucosa but the type of diabetes doesn’t seem to be effective on these changes.

Exfoliative cytology of oral epithelial cells from patients with type 2 diabetes: cytomorphometric analysis

This research objective is to identify cytomorphometrical changes using exfoliative cytology (EC) and later Papanicolaou (Pap) staining, for oral epithelial cells of patients with type 2 diabetes (DM2) (n = 30), while being compared to patients without the disease (n = 30). Additionally, we investigated an association between cellular changes and salivary flow levels; relationship that until now has not been reported. Results show that the cell diameter and the nuclear-cytoplasmic ratio was significantly higher compared to those patients without the disease (p ≤ 0.001 Student and Welch test). Decreased salivary flow was significantly associated with increased cell diameter and nuclear-cytoplasmic ratio (p ≤ 0.001 ANOVA with Tukey test). Evidence and clinical observations show that DM2 and decreased salivary flow are related to detectable cytomorphometrical changes in exfoliated cells, which may extend the horizon of this cytological technique.