Evaluation of micronuclei, cytomorphometric and cytologic changes of the oral mucosa in hookah and cigarette smokers

Objective: To analyze the effect of hookah and cigarette in the oral mucosa of smokers, through the use of exfoliative cytology. Study Design: Smear samples were collected by exfoliative cytology from the tongue from 33 hookah smokers, 22 cigarette smokers, and 30 non-smokers. The selected analyzes include micronuclei (MN), metanuclear anomalies, epithelial maturation and cytomorphology (nuclear area - NA, cytoplasmic area - CA and NA/CA ratio). Results: The largest differences observed for MN and metanuclear anomalies were between cigarette smokers and control group (notably 1MN p= 0.04; total cells with MN p=0.039; total MN p=0.042; karyorrhexis and binucleation, p=0.0001). The hookah group compared to the control group showed the greatest differences for kariolysis (p=0.0023), binucleation (p=0.0003) and broken-egg (p=0.008). Significant differences were found between the smokers and the control groups regarding changes in the superficial cell without nucleus, perinuclear halo, vacuolization, color change, mucus and keratohyalin granules. There was a significant increase in the NA and NA/CA ratio in smoker groups. Conclusion: This study showed that a combined analysis of exfoliative cytology associated with other diagnostic methods is a useful tool to study oral carcinogenesis. Hookah and cigarette showed similar effects in terms of displaying substantial cytogenetic and cytotoxic damage.