Assessment of Cytological Changes in Buccal Smears, among Cigarette Smokers in Khartoum state

Abstract

This is a case/control study conducted in Khartoum state during the period from April 2005 to July 2005 inclusive. The objective of the study was to apply cytological methods to detect the presence of cytological changes(atypia & inflammatory cells) in buccal mucosa, of cigarette smokers. The study assessed the cytological atypia among 50 cigarette smokers (cases),and 50 non-tobacco users (controls). Analysis of the smears identified atypia in 8 (8%) of the cases and only one atypia was detected among control group. Among the cases, 3(3%) showed moderate atypia and 5(5%) mild atypia. Therefore, cigarette smoking is a risk factor for occurrence of oral epithelial atypia and this was found to be statistical significant (P<0.004). Furthermore, inflammatory infiltrate was frequently observed among cases 8(8%), hence, only 2(2%) detected among controls. Concerning cytological stains, Pap. stain showed optimum results and appears to be superior to Harris haematoxyline. Factor such as age, intensity and duration of cigarette smoking should be considered, when assessing oral cytology. Exfoliative cytology appears to be of a value in detection of pre- malignant, malignant conditions and different types of inflammations as well as benign degenerative changes. Cigarette smokers should be undergo regular oral cytological screening programs. We recommend the use of exfoliative cytology as screening tool for different oral lesions.