Comparison of cytological findings of the buccal mucosa between smokers and non smokers

In the past few years an alarming rise in the occurence of oral and oropharyngeal squamous cell carcinoma which now comprises 3% of all cancers in men and 2% of all cancers in women has been seen. Tobacco smoking is a single most well-known and important risk factor for squamous cell carcinoma in oral cavity. However, the pathogenesis, especially the initial changes brought about by smoking is not fully understood. The aim of this study is to compare cytological findings of apparently normal buccal mucosa among smokers and nonsmokers based on samples obtained by brush biopsy.

Thirty-eight smokers and 42 nonsmokers, who did not show any conspicuous oral lesions were evaluated in a cross-sectional study. The specimens were taken from healthy and apparently normal buccal mucosa by a commercial cytobrush. Cytologic evaluation of biopsy specimens in terms of frequency of dysplasia/neoplasia, granular cells, binuclear cells, coarse chromatin, clear nucleus, apoptotic cells, pleomorphism in nuclear and cytoplasmic morphology was performed. Chi square test was used for comparison and analysis.

Studied samples included 80 men (mean age, 40 years) in both groups. There was no dysplastic or neoplastic changes in any of the groups. Cytologic studies demonstrated that clear nucleus, coarse chromatin and the frequency of nuclear pleomorphism showed statistically significant differences between the two groups (P<01, P<001 and P<01 respectively).

Buccal mucosa of smokers showed some differences compared to samples from nonsmokers. However, the clinical significance of these changes is uncertain.