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Comparative cytology of the oral cavities of snuff users
1Cytotechnology Program, Indiana University School of Medicine, Indianapolis, USA.
Objective:
To determine the effects of smokeless tobacco (snuff) on the epithelium of the oral cavity.
Study Design:
Cytologic smears were taken from the oral cavities of 22 snuff users and 19 control subjects. The samples were stained with the Papanicolaou method and accessed for cellularity, anucleated cells, micronuclei and broken egg nuclei.
Results:
An average of 7,624 cells per slide were found in the user group and 1,348 in the control. An average of 3,619 (47.5%) anucleated cells in the user group and 33.1 (2.5%) in the control were found per slide. Users with lesions had a significantly higher rate of anucleation than those without lesions. A total of 216 micronuclei were found in the user group and 46 in the control group. The broken egg nucleus was commonly found in both groups. The broken egg phenomenon is described as a nucleus that is in two portions and connected by a thin band of Feulgen-negative material.
Conclusion:
The regular use of snuff causes loss of cell cohesion, hyperkeratosis and an increased incidence of micronuclei. The relationship of these conditions to the development of oral cancer is unclear. The most likely anomaly that may be associated with carcinogenesis is the micronucleus.