Abstract:
In this case - control study, lung epithelial atypia and cellular
proliferative activity were assessed in sputum from Shisha smokers by
applying Papanicolaou method and mean AgNOR counts.
The study was conducted in Khartoum state during the period from
December 2009 to July 2010. Sputum specimens were obtained from 200
apparently healthy volunteers of whom, 100 were Shisha smokers (50 were
males and 50 were females), ascertained as cases and the remaining 100
were non-tobacco users (controls). Their ages ranged from 18 to 50 years
with a mean age of 28 years.
Cytological atypia was identified in (2%) Shisha users and, non was
found in control group.
Shisha smoking is a risk factor for occurrence of the squamous
metaplasia in the respiratory epithelium, 42% of the smokers and 7% of the
controls showed metaplasia (P value < 0.001).
Smokers were more susceptible to infections and inflammation than
controls, 43% and 23% of the cases (smokers) had acute and chronic
inflammation, respectively, compared to 3% (for each acute and chronic
inflammation) in controls (P value < 0.001). The Shisha use is the major
causative factor for inflammation.
The mean AgNOR counts in the cases was (±2.1) statistically higher
than control group (<2) (P value < 0.0001).
It was concluded that, Shisha smoking is high risk factor for atypia,
squamous metaplasia and increase the cellular proliferation in the respiratory
epithelium and the cytological proliferative markers methods are useful for
screening the Shisha users.