Evaluation of copper salivary level in oral squamous cell carcinoma, occupationally copper exposed, and its normal population and its association with cytomorphologic changes of oral mucosa

Oral squamous cell carcinoma (SCC) is one of the most common malignancies in oral cavity. Hence, presenting methods for early diagnosis and find the etiologic factors of oral SCC are important. Saliva analysis can be used to discover various conditions because of its noninvasive methods. Copper as a useful metal has been used by men since ancient times. The level of copper increases when the cancerous changes occur in addition to biopsy, an alternative method for examining oral lesions is exfoliative cytology. The primary objective of this study was to determine the salivary copper level and cytomorphologic changes of oral mucosa among three study groups.

This cross‑sectional study included 15 individuals with oral SCC, 15 workers exposed to copper, and 15 healthy individuals. Saliva samples were collected and analyzed by atomic absorption spectrophotometer. The exfoliative smears were prepared by brush biopsy and stained by Papanicolaou and argyrophilic nucleolar organizer region (AgNOR) staining methods. Data analysis using one‑way ANOVA and Kruskal–Wallis test. P < 0.05 was considered significant.

There was a significant difference in mean salivary copper (P = 0.008), cytomorphology of oral mucosa, and AgNOR among the three groups (P < 0.001).

The results suggested that occupational exposure to copper increases the salivary levels of this element and causes changes in mucosal cells. Since this increase was very high and evidence of nuclear activity was seen in this group and in oral SCC patients, exposure to copper should be considered an important risk factor for oral mucosal changes.