title: Assessment of oral cytological features in smokers and nonsmokers after application of toluidine blue.
abstract: BACKGROUND
  Smoking is the most important etiologic factor of oral cancer. Exfoliative cytology is the best method for early detection of oral cancer. Toluidine blue staining is used for detection of oral premalignant and malignant lesions. The aim of this study was to enhance the accuracy of oral exfoliative cytology in evaluating dysplastic features using toluidine blue staining.
  
  
  METHODS
  This clinical trials study was performed on 60 male smokers and nonsmokers without clinically oral lesion. Oral exfoliative cytological smears were prepared before and after application of toluidine blue and stained with Papanicolaou and evaluated under light microscope. Cytological features such as cellular clumping nuclear-to-cytoplasmic ratio, cellular and nuclear pleomorphism, micronuclei, binucleation, presence of bacterial colonies, and keratin flakes were assessed and compared before and after application of toluidine blue.
  
  
  RESULTS
  Results showed that cellular clumping and micronuclei were significantly decreased after application of toluidine blue and conversely cellular and nuclear pleomorphisms were significantly increased. Frequency of micronuclei and binucleation were greater in smokers than nonsmokers which were insignificant. Cellular and nuclear pleomorphisms were significantly higher in smokers than nonsmokers after application of toluidine blue.
  
  
  CONCLUSIONS
  Toluidine blue improved cellular, nuclear, and structural features of oral cytological smears and filtered false-positive or false-negative results. Thus, application of toluidine blue in combination with oral exfoliative cytology for early detection of oral cancer is recommended. Diagn. Cytopathol. 2017;45:513-519. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Sharbatdaran
authors.affiliation: Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Abbaszadeh
authors.affiliation: Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Siadati
authors.affiliation: Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ranaee
authors.affiliation: Department of Biostatistics and Epidemiology, Faculty of medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Karimollah
authors.initials: K
authors.lastname: Hajian-Tilaki
authors.affiliation: Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Mahdieh
authors.identifier: http://orcid.org/0000-0002-8276-0171
authors.initials: M
authors.lastname: Rajabi-Moghaddam
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D016022:Case-Control Studies; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008297:Male; D015162:Micronucleus Tests / Q000379:methods* / Q000592:standards; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D065006:Papanicolaou Test / Q000379:methods* / Q000592:standards; D012907:Smoking / Q000009:adverse effects*; D014048:Tolonium Chloride
chemical_list: D014048:Tolonium Chloride
keywords: cytology; smoking; toluidine blue