title: Cytomorphometric and cytomorphologic analysis of oral mucosa in children with sickle cell anemia.
abstract: BACKGROUND
  Sickle cell anemia (SCA) is an autosomal recessive genetic disorder, characterized by chronic hemolytic anemia, episodic painful crises, and pathologic involvement of many organs, consequence of vaso occlusive phenomenon and vasculopathy. Several forms of the chronic anemia, consequence of hemolysis, can be associated with oral epithelial cells changes. Exfoliative cytology can be used to detect real changes in the oral mucosa in SCA.
  
  
  OBJECTIVE
  To evaluate morphometric and morphological changes in oral epithelial cells by exfoliative cytology in children with SCA.
  
  
  METHODS
  Oral smears were collected from clinically normal-appearing mucosa by liquid-based exfoliative cytology in 20 SCA children (SCA group) and 20 healthy children (C group), matched for age and gender. The slides were prepared and stained by the Papanicolaou technique. Cell morphology and cellularity were analyzed and compared by Chi-square test (P < 0.05). Images of 50 cells per slide were captured and the nuclear area (NA) and cytoplasmic area (CA) were analyzed using an image analysis system. The nucleus-to-cytoplasmic area ratio (NA/CA) was calculated. To compare the means of groups SCA and C, the Student's t-test (P < 0.05) was applied to NA and CA; test non-parametric Mann Whitney U (P < 0.05) was used to compare NA/CA.
  
  
  RESULTS
  MEAN VALUES FOR SCA AND C GROUPS WERE: NA (69.38 and 59.63 μm²; P = 0.01); CA (2321.85 and 2185.60 μm²; P = 0.24); NA/CA (0.03 and 0.02; P = 0.13), respectively. A significant increase in NA for SCA group (P = 0.01) was seen. No morphological differences were found between the groups. There was a predominance of nucleated cells of the superficial layer in the smears of both groups. Class I smears were predominant in both groups.
  
  
  CONCLUSIONS
  This study revealed that SCA was able to induce significant changes on nuclear area of the oral epithelial cells.
authors.affiliation: Department of Dentistry, Biological and Health Sciences Center, Pontifical Catholic University of Paraná, Curitiba/PR, Brazil.
authors.forename: Juliana Umetsu
authors.initials: JU
authors.lastname: Paraizo
authors.forename: Itauana Aliete Vettorello
authors.initials: IA
authors.lastname: Rech
authors.forename: Luciana Reis
authors.initials: LR
authors.lastname: Azevedo-Alanis
authors.forename: Mara Albonei Dudeque
authors.initials: MA
authors.lastname: Pianovski
authors.forename: Antonio Adilson Soares
authors.initials: AA
authors.lastname: De Lima
authors.forename: Maria Ângela Naval
authors.initials: MÂ
authors.lastname: Machado
keywords: Anemia; cytology; mouth; oral mucosa; sickle cell