Oral Cytological Changes Among Yemeni Qat Users

Abstract

This study aimed to detect cytological typical changes in buccal mucosa among qat users. A total of 599 individuals were investigated, of whom 499 were qat chewers (cases) and 100 were non-qat users (control). The cytological smears were obtained from buccal mucosa using wooden tongue depressor, and participants underwent the Papanicolaou stain for cytological changes and AgNOR staining for evaluation of the mean number of AgNOR dots per nucleus. A significant correlation between qat use and oral cytological changes was found among cases compared to controls. Cytological atypia were verified among 25(5%) of the cases compared to 1(1%) of controls, (P= 0.02). Hence, keratinization was identified in 143(28.7%) of the cases compared to 11(11%) of controls, (P= 0.000). Acute inflammatory cells was identified in 55(11%) of the cases compared to 4(4%) of controls, (P= 0.03). Viral infection (koilocytes) detected by cytology in 53(10.6%) of the cases compared to 4(4%) of controls, (p= 0.02). and confirmed by ELISA in 45 of cases and in 2 of control. Fungal infection was observed in 16(3.2%) of the cases compared to 1(1%) of controls, (p= 0.05). Also a significant relation between oral epithelial atypia and duration, intensity of qat chewing. Statistical analyses revealed a greater mean number of AgNORs per nucleus in (cases) qat chewers (3.24) compared to (1.36) in non qat users (controls) (P= 0.00). And the mean of AgNOR count increase with duration of qat chewing and this was found to be statistically significant (P= 0.002). This study concluded that the qat chewers a risk factor caused cytological changes in oral mucosa and this cytological changes particular oral epithelial atypia associated with duration and intensity of qat chewing. In addition to the mean AgNORs count is a useful indicator for cellular proliferation activity in oral epithelium and for prediction of the risk of exposure to certain carcinogenic elements that may induce oral cancer.