Nuclear and Cytoplasmic Changes in Buccal Mucosal Cells of Alcoholic, Premalignant and Betel Quid/Nut Chewing with Tobacco (BQT) Cases

Introduction: Oral cytopathological techniques are widely used in the detection of malignant and premalignant lesions in cases of oral squamous cell carcinoma (OSCC) and to monitor clinically innocuous lesions complications in head and neck areas. The aim was to apply Papnicolaou (PAP), and Silver staining nuclear organizer regions (AgNOR) staining techniques to derive comparison and correlation of resulting parameters under study. Materials and Methods: 120 cases of normal, alcoholic, betel quid with tobacco (BQT) and premalignant individuals were considered for the study. PAP and AgNOR staining were carried out to analyse cytoplasmic diameter (CD), nuclear diameter (ND), nuclear area (NA), cytoplasmic area (CyA), nuclear-to-cytoplasmic ratio (NA:CyA), and AgNOR scoring parameters. Tukey's HSD multiple comparison tests and Pearson's correlation method were done to compare and correlate the variables under study. Results: When compared to controls, all the variables in all the groups (except AgNOR counts in alcoholic group) in the study showed a significant difference compared to controls. Similarly, correlation tests emphasized on significant diagnostic correlation between variables in all the groups with respect to controls (except ND and AgNOR count in alcoholic group, and CD and ND in premalignant group) under study. Conclusion: Determination of cell and nuclear diameter by computer-assisted cytomorphometry and AgNOR staining methods are prominent reliable markers in the diagnosis of neoplastic, premalignant and malignant lesions. Also, being economical, effective and non-invasive, these simple techniques can be combined and standardized for optimal monitoring and detection of oral cancers.