Changes in vitamin A conditioned hamster cheek pouch epithelium on exposure to commercial shell lime (calcium hydroxide) and tobacco. I-Optical histopathology.

Epidemiologically a high incidence of oral cancer and addiction to tobacco, singly or in combination with other ingredients of the betel quid, are closely correlated. Attempts at the induction of malignancy in laboratory animals on exposure to these ingredients have hitherto failed. Studies are reported on cheek pouch epithelium of 152 Syrian golden hamsters exposed to commercial shell lime (calcium hydroxide) and tobacco, singly and in combination, with parallel conditioning by Vitamin A palmitate. The abnormal changes found especially in lime and lime-plus-tobacco treated epithelia are massive hyperplasia, keratinization anomalies, marked edema and dysplasia. The most significant findings are (1) greater epithelial alteration caused by lime, lime plus vitamin A, tobacco plus vitamin A, lime plus tobacco and lime plus tobacco and vitamin A, than by tobacco alone; (2) increasing epithelial dysplasia in response to longer periods of exposure to the test substances; and (3) enhancement of tissue changes in the presence of vitamin A.