title: Clinical and cytological study of the oral mucosa of smoking and non-smoking qat chewers in Yemen.
abstract: OBJECTIVE
  The study was conducted to investigate the role of qat and smoking habits on the prevalence of visible and cytological abnormalities in the oral mucosa among Yemenites.
  
  
  METHODS
  We recruited 30 non-smoking and 30 smoking Yemenites chewing qat unilaterally for at least 5 years. We inspected oral cavities for the presence of lesions and took brush biopsies from the buccal mucosa/gingiva of the chewing/non-chewing region.
  
  
  RESULTS
  All visible oral lesions were flat and homogeneous, and cytological changes were detected frequently. Among both non-smokers and smokers, white lesions and cytological changes were detected in 77% of all cases. On the chewing area, the proportion with white lesions ranged--depending on anatomical area and smoking status--between 47 and 93% and was significantly more frequent than on the non-chewing side (range 3-47%). The proportion of regions with changes was similar in non-smokers and smokers. Kappa statistics for "interobserver" agreement between visual inspection and cytological specimens of brush biopsies was at best fair (≤0.25).
  
  
  CONCLUSIONS
  The high prevalence of visible lesions and cytological abnormalities among qat chewers was independent of smoking status.
  
  
  CONCLUSIONS
  The moderate level of agreement between visual inspection and exfoliative cytology demonstrates the still challenging clinical management of chronic qat chewers, though brush biopsies including adjuvant techniques like DNA cytometry may support the clinical decision-making process in future.
authors: Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
authors: M
authors: M
authors: Hijazi
authors: Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
authors: H
authors: H
authors: Jentsch
authors: Department of Oral Medicine, Faculty of Dentistry, University of Thamar, Thamar, Republic of Yemen.
authors: J
authors: J
authors: Al-Sanabani
authors: Joint Practice for Pathology, IPO Institute for Pathology, Berlin, Germany.
authors: M
authors: M
authors: Tawfik
authors: Section of Oral Medicine, Department of Head Medicine and Oral Health, Leipzig University Hospital, Liebigstraße 10-14, 04103, Leipzig, Germany. torsten.remmerbach@medizin.uni-leipzig.de.
authors: T W
authors: TW
authors: Remmerbach
mesh_terms: D029754:Catha / Q000009:adverse effects*; D006801:Humans; D008409:Mastication; D009059:Mouth Diseases / Q000453:epidemiology / Q000209:etiology*; D009061:Mouth Mucosa / Q000473:pathology*; D012907:Smoking; D015006:Yemen / Q000453:epidemiology
keywords: Oral white lesions; Qat; Smoking