Cytomorphometric Study of Changes in Buccal Mucosal Cells in Alcoholics

Srinivasamurthy, Banushree Chandrasekhar; Balamurugesan, K; Sathishkumar, N; Prakash, M; V Bhat, Ramachandra

Cytomorphometric Study of Changes in Buccal Mucosal Cells in Alcoholics

Document Type : Original Article

Authors

Banushree Chandrasekhar Srinivasamurthy ¹
K Balamurugesan ²
N Sathishkumar ³
M Prakash ⁴
Ramachandra V Bhat ¹

¹ Department of Pathology, Indira Gandhi Medical College and Research Institute, Puducherry, India

² Department of Medicine, JIPMER, Puducherry, India

³ Department of Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India

⁴ Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India

Abstract

Background: Chronic alcohol consumption carries a high risk for oral and pharyngeal cancers among persons who have never smoked. Excessive alcohol consumption displays cytogenetic changes in oral mucosa cells. Cytomorphometric analysis of oral mucosal cells helps in the early detection of cytomorphological transformations in alcoholics before and after the onset of carcinoma. Materials and Methods: A prospective, hospital-based, comparative study was done after written informed consent. Smears were obtained from the clinically normal buccal mucosa of 102 randomly selected alcoholic patients attending the medicine outpatient department aged above 25 years who consumed a minimum of 45 ml alcohol per day for at least 10 years and of 102 nonalcoholics as control. The slides were immediately fixed in absolute methanol and stained by the Papanicolaou (Pap) staining technique. PAP-stained smears were examined under the light microscope. Using the image J 1.47 image analysis software, a morphometric analysis of around 50 cells/case was done. Results: A statistically significant increase in mean cytoplasmic area (P < 0.001), mean nuclear area (P < 0.01), and cell-to-nuclear parameter ratio (P < 0.001) was seen in the alcohol group in comparison with the control group. Conclusion: Prolonged consumption of alcohol produces cytomorphometric changes in buccal mucosal cells before the onset of premalignant lesions.

Keywords

References

1.	Gupta PC, Sinor PN, Bhonsle RB, Pawar VS, Mehta HC. Oral submucous fibrosis in India: A new epidemic? Natl Med J India 1998;11:113-6.
2.	Razavi SM, Sajadi S. Epidemiological study of oral and perioral cancers in Isfahan. Dent Res J 2007;4:18-25.
3.	Seitz HK, Becker P. Alcohol metabolism and cancer risk. Alcohol Res Health 2007;30:38-41, 44-7.
4.	Seitz HK, Stickel F, Homann N. Pathogenetic mechanisms of upper aerodigestive tract cancer in alcoholics. Int J Cancer 2004;108:483-7.
5.	Fioretti F, Bosetti C, Tavani A, Franceschi S, La Vecchia C. Risk factors for oral and pharyngeal cancer in never smokers. Oral Oncol 1999;35:375-8.
6.	Carrard VC, Filho MS, Rados PV, Chaves AC, Lauxen Ida S. Quantification of silver-staining nucleolar organizer region in epithelial cells of tongue of mice after exposure to, or intake of, alcohol. Alcohol 2004;34:233-8.
7.	Carrard VC, Pires AS, Mendez M, Pasquali AB, Badauy CM, Lauxen IS, et al. Exploring the mechanisms of alcohol-related damage in oral mucosa-is oxidative stress associated with the increase in cell proliferation in rat tongue epithelium? Pharm Biol 2013;51:160-9.
8.	Homann N, Jousimies-Somer H, Jokelainen K, Heine R, Salaspuro M. High acetaldehyde levels in saliva after ethanol consumption: Methodological aspects and pathogenetic implications. Carcinogenesis 1997;18:1739-43.
9.	Gupta PC, Metha FS, Pindborg JJ. Oral cancer in rural India. Lancet 1987;1:1087.
10.	Sampaio HC, Loyola AM, Gomez RS, Mesquita RA. AgNOR count in exfolioative cytology of normal buccal mucosal effect of smoking. Acta Cytol 1999;43:117-120.
11.	Hunter KD, Parkinson EK, Harrison PR. Profiling early head and neck cancer. Nat Rev Cancer 2005;5:127-35.
12.	Orellana-Bustos AI, Espionoza-Santander IL, Franco-Martínez ME, Lobos-James-Freyre N, Ortega-Pinto AV. Evaluation of keratinisation and AgNORs count in exfoliative cytology of normal oral mucosa from smokers and non-smokers. Med Oral 2004;9:197-203.
13.	Diniz-Freitas M, García-García A, Crespo-Abelleira A, Martins-Carneiro JL, Gándara-Rey JM. Applications of exfoliative cytology in the diagnosis of oral cancer. Med Oral 2004;9:355-61.
14.	Ogden GR, Cowpe JG, Wight AJ. Oral exfoliative cytology: Review of methods of assessment. J Oral Pathol Med 1997;26:201-5.
15.	Pektaş ZO, Keskin GO, Karslioǧlu Y. Evaliuation of nuclear morphometry and DNA ploidy status for detection of malignant and premalignant oral lesions: Quantitative cytologic assessment and review of methods for cytomorphometric measurements. J Oral Maxillofac Surg 2006;64:628-35.
16.	Webber LP, Pellicioli AC, Magnusson AS, Danilevicz CK, Bueno CC, Sant'Ana Filho M, et al. Nuclear changes in oral mucosa of alcoholics and crack cocaine users. Hum Exp Toxicol 2016;35:184-93.
17.	Parmar D, Indupalli AS, Sawke N, Sawke GK. Cytomorphometric evaluation of alterations in buccal mucosal cells of smokers and non-smokers. Int J Bioassays 2014;3:1775-9.
18.	Cowpe JG. Quantitative exfoliative cytology of normal and abnormal oral mucosal squames: Preliminary communication. J R Soc Med 1984;77:928-31.
19.	Sharma D, Sandhu SV, Bansal H, Gupta S. Distinct perturbations of oral squamous cell carcinoma patients: A quantitative cytomorphometric analysis. Int J Health Sci (Qassim) 2015;9:283-91.
20.	Cowpe JG, Longmore RB, Green MW. Quantitative exfoliative cytology of abnormal oral mucosal smears. J R Soc Med 1988;81:509-13.
21.	Patel PV, Kumar S, Kumar V, Vidya G. Quantitative cytomorphometric analysis of exfoliated normal gingival cells. J Cytol 2011;28:66-72. [PUBMED] [Full text]
22.	Sudbo J, Kildal J, Risberg B, Koppang HS, Danielsen HE, Reith A. DNA content as a prognostic marker in patients with oral leukoplakia. N Engl J Med 2001;344:1270-8.
23.	Feng L, Wang L. Effects of alcohol on the morphological and structural changes in oral mucosa. Pak J Med Sci 2013;29:1046-9.
24.	Reidy JT, McHugh EE, Stassen LF. A review of the role of alcohol in the pathogenesis of oral cancer and the link between alcohol-containing mouthrinses and oral cancer. J Ir Dent Assoc 2011;57:200-2.
25.	Ogden GR, Wight AJ, Rice P. Effect of alcohol on the oral mucosa assessed by quantitative cytomorphometry. J Oral Pathol Med 1999;28:216-20.
26.	Reis SR, do Espírito Santo AR, Andrade MG, Sadigursky M. Cytologic alterations in the oral mucosa after chronic exposure to ethanol. Braz Oral Res 2006;20:97-102.
27.	Batista AB, Hase ED, Grégio AMT, Ignácio SA, França BHS, Soares de Lima AA. Cytomorphometric study of normal buccal mucosa of alcoholic individuals. Pharmacologyonline 2007;1: 243-251.
28.	Mohanta A, Mohanty PK. Nuclear pleomorphism-based cytopathological grading in human oral neoplasm. Russian Open Med J 2017;6:E0203.
29.	Radhika T, Hussain S, Adithyan S, Jeddy N, Lakshmi S. Cytomorphometric evaluation of oral exfoliated cells − Its correlation with age of an individual. J Orofac Sci 2019;11:84-8. [Full text]
30.	Sahay K, Rehani S, Kardam P, Kumra M, Sharma R, Singh N. Cytomorphometric analysis and morphological assessment of oral exfoliated cells in type 2 diabetes mellitus and healthy individuals: A comparative study. J Cytol 2017;34:27-33. [PUBMED] [Full text]

Advanced Biomedical Research