Lung Epithelial Atypia among Sudanese Shisha Smokers

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.