Assessment of Cellular Proliferative Activity in Buccal Mucosa of Toombak Users in El-Obied City

Abstract

This is a descriptive prospective study to identify the cellular proliferative activity by Papanicolaou stain and mean AgNOR counts of the buccal mucosa of toombak users and non-Toombak Users in brush smears. The study was conducted in North Kordofan State – El-Obied during the period from April 2009 to August 2009. The smears were obtained from 200 apparently healthy male individuals, 100 were toombak users (cases) and the remaining hundred were non-tobacco users (controls), their ages ranging from 11 to 70 years with a mean age of 26 years. The mean age for the cases was (27.5 ±11 years), hence, the mean age for the controls was (24 ±10 years). All of the cases were identified with keratinization; hence, only one study subject was identified with keratinization among control group due to alcohol drinking. Out of the 100 cases, 47 (47%) individuals were demonstrated with low keratinization and the remaining 53 (53%) persons were demonstrated with excessive keratinization (P < 0.0001). Higher proportions of low keratinization were found in duration range less than 10 years while High frequency of excessive keratinization was detected in duration range more than 11 years. In regard to the age, excessive keratinization is relatively increased with increasing of age. In regard to the infections and inflammatory conditions, cases were more susceptible than controls, erosions and exposure of oral mucosa to toombak irritation are the major causative factors. In the measurement of the AgNORs, 26 (26%) of the cases showed abnormal NOR count. Statistically, the mean AgNORs counts for the controls (1.56 ±0.41) was lower than that for the cases (2.35 ±1.6) (P < 0.0001). However, 20 (10%) and 6 (3%) of the specimens showed excessive and low keratinization respectively (P < 0.03). These findings support that toombak dipping is a high risk factor for oral mucosal proliferative lesions and AgNORs and Papanicolaou tests are used as screening methods for toombak users.