Verma Renuka, Singh Anil, Badni Manjunath, Chandra Akhilesh, Gupta Shalini, Verma Ruchita
Department of Oral and Maxillofacial Pathology, Career Post Graduate Institute of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India.
Department of Oral and Maxillofacial Pathology, Sardar Patel Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India.
Dent Res J (Isfahan). 2015 Jan-Feb;12(1):83-8. doi: 10.4103/1735-3327.150339.
Many oral squamous cell carcinomas (OSCCs) arise within regions that previously had premalignant lesion. Early diagnosis and prompt treatment of premalignant lesions offers the best hope of improving the prognosis in patients with OSCC. Exfoliative cytology is a simple and non-invasive diagnostic technique that could be used for early detection of oral premalignant and malignant lesions. This study was undertaken to evaluate the quantitative changes in nuclear area (NA), cytoplasmic area (CA) and nuclear-to-cytoplasmic ratio (NA/CA) in cytological buccal smears of oral leukoplakia with dysplasia (OLD) and OSCC patients while comparing with normal healthy mucosa.
A quantitative study was conducted over 90 subjects including 30 cases each of OLD, OSCC and clinically normal oral mucosa. The smears obtained were stained with Papanicolaou (PAP) stain and cytomorphological assessment of the keratinocytes was carried out. The statistical tools included arithmetic mean, standard deviation, Chi-square test, analysis of variance, Tukey multiple comparison. P < 0.001 was considered as significant.
The mean NA of keratinocytes in the normal mucosa was 65.47 ± 4.77 μm(2) while for OLD it was 107.97 ± 5.44 μm(2) and 139.02 ± 8.10 μm(2) for that of OSCC. The differences show a statistically significant increment in NA (P < 0.001). There was significant reduction (P < 0.001) in the CA of keratinocytes from OSCC when compared with those from smears of OLD and normal mucosa with the values of 1535.80 ± 79.38 μm(2), 1078.51 ± 56.65 μm(2) and 769.70 ± 38.77 μm(2) respectively. The NA/CA ratio in the smears from normal oral mucosa, OLD and OSCC showed a mean value of 0.043 ± 0.004, 0.100 ± 0.008, 0.181 ± 0.015 respectively with a significant difference among the groups (P < 0.001).
Evaluation of nuclear and CA of keratinocytes by cytomorphometry can serve as a useful adjunct in the diagnosis and prognosis of a dysplastic lesion which may lead to OSCC.
许多口腔鳞状细胞癌（OSCC）发生于先前存在癌前病变的区域。癌前病变的早期诊断和及时治疗为改善OSCC患者的预后提供了最大希望。脱落细胞学是一种简单且无创的诊断技术，可用于口腔癌前和恶性病变的早期检测。本研究旨在评估发育异常的口腔白斑（OLD）和OSCC患者的细胞学颊黏膜涂片的核面积（NA）、细胞质面积（CA）和核质比（NA/CA）的定量变化，并与正常健康黏膜进行比较。
对90名受试者进行了一项定量研究，其中包括30例OLD、30例OSCC和30例临床正常口腔黏膜患者。所获得的涂片用巴氏（PAP）染色，并对角化细胞进行细胞形态学评估。统计工具包括算术平均值、标准差、卡方检验、方差分析、Tukey多重比较。P < 0.001被认为具有统计学意义。
正常黏膜中角质形成细胞的平均NA为65.47±4.77μm²，而OLD为107.97±5.44μm²，OSCC为139.02±8.10μm²。这些差异显示NA有统计学意义的增加（P < 0.001）。与OLD涂片和正常黏膜涂片相比，OSCC角质形成细胞的CA显著降低（P < 0.001），其值分别为1535.80±79.38μm²、1078.51±56.65μm²和769.70±38.77μm²。正常口腔黏膜、OLD和OSCC涂片的NA/CA比值分别为0.043±0.004、0.100±0.008、0.181±0.015，各组之间有显著差异（P < 0.001）。
通过细胞形态计量学评估角质形成细胞的核和CA可作为发育异常病变（可能导致OSCC）诊断和预后的有用辅助手段。
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