title: Comparative cytomorphometric analysis of oral mucosal cells in normal, tobacco users, oral leukoplakia and oral squamous cell carcinoma.
abstract: BACKGROUND
  Squamous cell carcinoma (SCC) is the third most common cause of oral morbidity in India despite the numerous advances made in the treatment protocol.
  
  
  OBJECTIVE
  To compare the cytomorphometric changes of oral mucosal cells in normal subjects (Group I) with that of tobacco users without any lesion (Group II), tobacco users with oral leukoplakia (Group III), and tobacco users with oral SCC (Group IV) through a semi-automated image analysis system.
  
  
  METHODS
  Oral mucosal cells collected from study subjects (n = 100) stained using rapid Papanicolaou stain. Photomicrograph of 50 nonoverlapping cells captured at 50× magnification with a digital image capture system. Cytomorphometric analysis of cells in the captured images was performed with Image-Pro image analysis software. Image analysis was performed to obtain cell diameter (CD), cytoplasmic area (CyA), nuclear diameter (ND), nuclear area (NA), and nuclear-to-cytoplasmic ratio. These values were statistically compared among the groups using one-way analysis of variance (ANOVA) and Mann-Whitney U test.
  
  
  RESULTS
  The ND, NA, and nuclear-to-cytoplasmic ratio values were found to be increased in the samples collected from leukoplakia and oral SCC. The CD and CyA decreased compared to the normal mucosa in oral SCC samples.
  
  
  CONCLUSIONS
  The cytomorphometric changes observed in samples from oral SCC and oral leukoplakia were consistent with the current diagnostic features. Hence, the semi-automated cytomorphometric analysis of oral mucosal cells can be used as an objective adjunct diagnostic tool in the diagnosis of these lesions.
authors.affiliation: Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Trivandrum, Kerala, India.
authors.forename: Mahadoon
authors.initials: M
authors.lastname: Nivia
authors.affiliation: Department of Oral and Maxillofacial Pathology, Pushpagiri College of Dental Sciences, Trivandrum, Kerala, India.
authors.forename: Sukumaran Nair
authors.initials: SN
authors.lastname: Sunil
authors.affiliation: Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Trivandrum, Kerala, India.
authors.forename: Ravindran
authors.initials: R
authors.lastname: Rathy
authors.affiliation: Department of Veterinary Pathology, Division of Experimental Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Thapasimuthu Vijayamma
authors.initials: TV
authors.lastname: Anilkumar
keywords: Cytomorphometry; Papanicolaou stain; leukoplakia; oral squamous cell carcinoma (SCC)
references.citation: Mol Cancer. 2006 Mar 23;5:11
references.pmid: 16556320
references.citation: Tob Induc Dis. 2004 Mar 15;2(1):43-9
references.pmid: 19570270
references.citation: J R Soc Med. 1985 Dec;78(12):995-1004
references.pmid: 4067983
references.citation: J Cytol. 2011 Apr;28(2):66-72
references.pmid: 21713150
references.citation: Oral Oncol. 2011 Nov;47(11):1005-10
references.pmid: 21865078
references.citation: J Dent Educ. 2001 Apr;65(4):306-12
references.pmid: 11336115
references.citation: J Epidemiol Community Health. 1990 Dec;44(4):286-92
references.pmid: 2277249
references.citation: Arch Pathol Lab Med. 2006 Jan;130(1):57-61
references.pmid: 16390239
references.citation: Head Neck Pathol. 2008 Sep;2(3):157-62
references.pmid: 20614310
references.citation: Oral Surg Oral Med Oral Pathol. 1964 May;17:668-76
references.pmid: 14131588
references.citation: J Oral Pathol Med. 1998 Feb;27(2):83-6
references.pmid: 9526735
references.citation: Contemp Clin Dent. 2012 Sep;3(Suppl 2):S156-9
references.pmid: 23230352
references.citation: Br J Cancer. 1977 Feb;35(2):232-5
references.pmid: 836760
references.citation: J Oral Pathol. 1981 Apr;10(2):81-6
references.pmid: 6792334
references.citation: J Oral Pathol Med. 1990 Feb;19(2):53-5
references.pmid: 2187974
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):246-53
references.pmid: 18644521
references.citation: Eur J Cancer B Oral Oncol. 1993 Oct;29B(4):265-71
references.pmid: 11706419
references.citation: Int J Oral Sci. 2010 Mar;2(1):45-52
references.pmid: 20690418
references.citation: J Chin Med Assoc. 2009 May;72(5):227-33
references.pmid: 19467945
references.citation: Rom J Morphol Embryol. 2010;51(3):527-32
references.pmid: 20809031
references.citation: Indian J Dent Res. 2003 Apr-Jun;14(2):87-93
references.pmid: 14705452
references.citation: Oral Surg Oral Med Oral Pathol. 1970 Jul;30(1):131-41
references.pmid: 5269800
references.citation: J Oral Pathol Med. 2009 Feb;38(2):161-6
references.pmid: 19213102
references.citation: Indian J Dent Res. 2007 Apr-Jun;18(2):63-6
references.pmid: 17502710