Head and Neck Pathology

, 2:157 | Cite as

Comparison of Exfoliative Pap Stain and AgNOR Counts of the Tongue in Smokers and Nonsmokers

  • Patrícia Campos Fontes
  • Gustavo Henrique Marques Corrêa
  • Jaqueline Scholz Issa
  • Adriana Aigotti Haberbeck Brandão
  • Janete Dias Almeida
Original Paper

Abstract

Objective To compare exfoliative cytology from the oral mucosa of smokers and nonsmokers, with emphasis on proliferative activity. Methods Exfoliative cytology specimens were obtained from clinical normal mucosa from the lateral border of the tongue in 30 nonsmokers and 30 smokers ranging in age from 40 to 70 years of age, who were seen at the Heart Institute’s Patient Center and the Smoking Cessation Program of the University Hospital, University of São Paulo Medical School (InCor-HCFMUSP). The cytologic specimens were evaluated by Papanicolaou staining and AgNOR quantification in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. Results Only Papanicolaou Class I and Class II smears were observed. Inflammatory alterations were found in 90% of smokers and in 87% of nonsmokers. The number of AgNORs/nucleus differed significantly between smokers and nonsmokers (3.372 ± 0.375 versus 2.732 ± 0.236). Conclusions Within the limitations of this research, the results indicate higher proliferative activity in smoking patients compared to nonsmoking patients, even in the absence of clinical lesions.

Keywords

Cytodiagnosis Smoking Nucleolar organizer region Disease prevention Oral mucosa 

Notes

Acknowledgments

The authors would like to thank Prof. Ivan Balducci for the statistical analysis. Research supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, grant 04/10520-2) and Fundação para o Desenvolvimento da UNESP (FUNDUNESP, grant 00279/04-DFP). The publication of this article was supported by the Program for the Internationalization of Research of UNESP.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

References

  1. 1.
    Banoczy J, Squier C. Smoking and disease. Eur J Dent Educ. 2004;8 Suppl 4:7–10.PubMedCrossRefGoogle Scholar
  2. 2.
    Castellsague X, Quintana MJ, Martinez MC, Nieto A, Sanchez MJ, et al. The role of type of tobacco and type of alcoholic beverage in oral carcinogenesis. Int J Cancer. 2004;108(5):741–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Sapp JP, Eversole LR, Wysocki GP. Contemporary oral and maxillofacial pathology. Los Angeles: CV Mosby; 1997. p. 174–80.Google Scholar
  4. 4.
    Taybos G. Oral changes associated with tobacco use. Am J Med Sci. 2003;326(4):179–82.PubMedCrossRefGoogle Scholar
  5. 5.
    Pavanello MB, Prado FA, Balducci I, Brandão AAH, Almeida JD. Cytological analysis of alterations induced by smoking and by alcohol consumption. Acta Cytol. 2006;50(50):435–40.PubMedGoogle Scholar
  6. 6.
    Winn DM. Tobacco use and oral diseases. J Dent Educ. 2001;65:306–12.PubMedGoogle Scholar
  7. 7.
    Stewart BW, Kleihues P. World cancer report. International Agency for Research on Cancer. Lyon: IARC Press; 2003. p. 22–7, 172–4.Google Scholar
  8. 8.
    BRASIL. Ministério da Saúde. Instituto Nacional do Câncer. Estimativas da incidência e da mortalidade por câncer no Brasil em 2006. Available at: http://www.inca.org.br/estimativas/2006/index.asp?=tabelaestados.asp
  9. 9.
    Fontes PC, Kitakawa D, Carvalho YR, Brandão AA, Cabral LAG, Almeida JD. Sporotrichosis in an HIV-positive man with oral lesions: a case report. Acta Cytol. 2007;51:648–50.PubMedGoogle Scholar
  10. 10.
    Almeida JD, Cabral LAG, Brandão AAG. Exfoliative cytology as a diagnostic method in Stomatology. J Dent Res. 1994;73:765.Google Scholar
  11. 11.
    Cançado RP, Yurgel LS, Sant’anna F. Evaluation of the nucleolar organizer regions associated proteins in exfoliative cytology of normal buccal mucosa. Effect of smoking. Oral Oncol. 2001;37:446–54.PubMedCrossRefGoogle Scholar
  12. 12.
    Ogden GR, Cowpe JG, Green MW. Quantitative exfoliative cytology of normal buccal mucosa: effect of smoking. J Oral Pathol. 1990;19:53–5.CrossRefGoogle Scholar
  13. 13.
    Chattopadhyay A, Ray JG, Caplan DJ. AgNOR count as objective marker for dysplastic features in oral leukoplakia. J Oral Pathol Med. 2002;31(9):512–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Eslami B, Yaghmaei M, Firoozi M, Saffar AS. Nucleolar organizer regions in selected odontogenic lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(2):187–92.PubMedCrossRefGoogle Scholar
  15. 15.
    Paiva RL, Sant′Ana Filho M, Bohrer PL, Lauxen Ida S, Rados PV. AgNOR quantification in cells of normal oral mucosa exposed to smoking and alcohol. A cytopathologic study. Anal Quant Cytol Histol. 2004;26(3):175–80.PubMedGoogle Scholar
  16. 16.
    Remmerbach TW, Weidenbach H, Muller C, Hemprich A, Pomjanski N, et al. Diagnostic value of nucleolar organizer regions (AgNORs) in brush biopsies of suspicious lesions of the oral cavity. Anal Cell Pathol. 2003;25(3):139–46.PubMedGoogle Scholar
  17. 17.
    Sethi P, Shah PM. Oral exfoliative cytology of smokers at discrete clinical stages using AgNOR staining. Indian J Dent Res. 2003;14(3):142–5.PubMedGoogle Scholar
  18. 18.
    Howell WM, Denton TE, Diamond JR. Differential staining of the satellite regions of human acrocentric chromosomes. Experientia. 1975;31(2):260–2.PubMedCrossRefGoogle Scholar
  19. 19.
    Gedoz L, Lauxen Ida S, Sant’Ana MF, Rados PV. Proliferative activity in clinically healthy oral mucosa exposed to tobacco smoking and alcohol: a longitudinal study using the AgNOR staining technique. Anal Quant Cytol Histol. 2007;29(4):231–8.PubMedGoogle Scholar
  20. 20.
    Hoffmann D, Wynder EL. Chemical constituents and bioactivity of tobacco smoke. IARC Sci Publ. 1986;74:145–65.PubMedGoogle Scholar
  21. 21.
    Trerè D. AgNOR staining and quantification. Micron. 2000;31:127–31.PubMedCrossRefGoogle Scholar
  22. 22.
    Crocker J, Bold DAR, Egan MJ. How should we count AgNORs? Proposals for a standardized approach. J Pathol. 1989;158:185–8.PubMedCrossRefGoogle Scholar
  23. 23.
    de Sampaio H C, Loyola AM, Gomez RS, Mesquita RA. AgNOR count in exfoliative cytology of normal buccal mucosa: effect of smoking. Acta Cytol. 1999;43(4):117–20.Google Scholar
  24. 24.
    Orellana-Bustos AI, Espinoza-Santander IL, Franco-Martínez ME, Lobos-James-Freyre N, Ortega-Pinto AV. Evaluation of keratinization and AgNORs counts in exfoliative cytology of normal mucosa from smokers and non-smokers. Med Oral. 2004;9(5):197–203.PubMedGoogle Scholar
  25. 25.
    Ploton D, Menager M, Jeannesson P, Himber G, Pigeon F, Adnet JJ. Improvements in the staining and in the visualization of the argyrophilic proteins of the nucleolar organizer region at the optical level. Histochem J. 1986;18:5–14.PubMedCrossRefGoogle Scholar
  26. 26.
    Fontes PC, Côrrea GHM, Issa JS, Almeida JD. Quantitative analysis of AgNOR proteins in exfoliative cytology specimens of oral mucosa from smokers and non-smokers. Anal Quant Cytol Histol. 2008;30:16–24.Google Scholar
  27. 27.
    Warnakulasuriya S, Reibel J, Bouquot J, Dabelsteen E. Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement. J Oral Pathol Med. 2008;37:127–33.PubMedGoogle Scholar
  28. 28.
    Driemel O, Hertel K, Reichert T, Kosmehi H. Current classification of precursor lesions of oral squamous cell carcinoma principles of the WHO classification 2005. Mund Kiefer Gesichtschir. 2006;10(2):89–93.PubMedCrossRefGoogle Scholar

Copyright information

© The Author(s) 2008

Authors and Affiliations

  • Patrícia Campos Fontes
    • 1
  • Gustavo Henrique Marques Corrêa
    • 2
  • Jaqueline Scholz Issa
    • 3
  • Adriana Aigotti Haberbeck Brandão
    • 4
  • Janete Dias Almeida
    • 4
  1. 1.Postgraduation Program in Oral Biopathology, São José dos Campos Dental SchoolUNESP – São Paulo State UniversitySao PauloBrazil
  2. 2.São José dos Campos Dental SchoolUNESP – São Paulo State UniversitySao PauloBrazil
  3. 3.Smoking Cessation Program, Heart Institute (InCor), Medical SchoolUniversity of São PauloSao PauloBrazil
  4. 4.Department of Biosciences and Oral Diagnosis, São José dos Campos Dental SchoolUNESP – São Paulo State UniversitySao PauloBrazil

Personalised recommendations