The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 19 , ISSUE 12 ( December, 2018 ) > List of Articles


Evaluation of Radiation-induced Cytological Changes in Lesional Oral Cancer Cells and Adjacent Normal Mucosal Cells

Vinit Patil, Rajendra Baad, Nupura Vibhute, Uzma Belgaumi, Vidya Kadashetti, Anand Gudur

Keywords : Cytology, Oral cancer, Radiosensitivity

Citation Information : Patil V, Baad R, Vibhute N, Belgaumi U, Kadashetti V, Gudur A. Evaluation of Radiation-induced Cytological Changes in Lesional Oral Cancer Cells and Adjacent Normal Mucosal Cells. J Contemp Dent Pract 2018; 19 (12):1475-1480.

DOI: 10.5005/jp-journals-10024-2452

License: CC BY-NC 4.0

Published Online: 01-02-2019

Copyright Statement:  Copyright © 2018; The Author(s).


Aim: To assess various cytological changes for predicting radiosensitivity of oral squamous cell carcinoma by exfoliative cytology. Materials and methods: Histologically proven 30 cases of oral squamous cell carcinoma who underwent fractionated radiotherapy in a dose of 45-60 Gy in 5 fractions/week were enrolled in the study. The exfoliative cytology smear was evaluated on lesional and adjacent oral mucosa before radiotherapy, during radiotherapy (8 and 11th fraction) and post radiotherapy (4, 6 and 8 weeks). Various parameters like multinucleation, cellular enlargement, nuclear enlargement, cytoplasmic vacuolation, cytoplasmic granulation, leukocytic infiltration were evaluated. Results: Statistical significant values were seen in the intergroup comparison of all the parameters when compared adjacent mucosa and normal mucosa for leukocytic infiltration in pretreatment smear. Conclusion: The study showed that radiation-induced cytological changes in oral squamous cell carcinoma have a significant dose-related increase. This dose-response relationship and the high intratumoral variations suggest that serial assay of these changes has potential use for radiosensitivity prediction. Clinical significance: Radiosensitivity prediction can be evaluated by means of cytological smears in one stop crisis centre (OSCC) individuals subjected to fractionated radiotherapy by evaluating the cytological parameters.

PDF Share
  1. Sugerman PB, Savage NW. Exfoliative cytology in clinical oral pathology. Australian dental journal. 1996 Apr 1; 41(2):71-74.
  2. Beale LS. Examination of sputum from a case of cancer of the pharynx and the adjacent parts. Arch Med. 1860;2(44):1860-1861.
  3. Lebert H. Traite pratique des maladies cancereuses. JB Baillière; 1851.
  4. Papanicolau GN. Atlas of exfoliative cytology. Cambridge, Mass. Harvard University Press. 1954.
  5. Papanicolaou GN, Traut HF. Diagnosis of uterine cancer by the vaginal smear. New York. 1943;46.
  6. Ayre JE. Cancer cytology of the uterus: introducing a concept of cervical cell pathology. Churchill; 1951.
  7. Montgomery PW. A study of exfoliative cytology of normal human oral mucosa. Journal of dental research. 1951 Feb 1; 30(1):12-18.
  8. Koss LG, Melamed MR, editors. Koss’ diagnostic cytology and its histopathologic bases. Lippincott Williams & Wilkins; 2006.
  9. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral oncology. 2009 May 31;45(4):309-316.
  10. Zheng JW, Qiu WL, Zhang ZY. Combined and sequential treatment of oral and maxillofacial malignancies: an evolving concept and clinical protocol. Chinese medical journal. 2008 Oct;121(19):1945-1952.
  11. Arneson AN, Stewart FW. Clinical and histologic changes produced in carcinoma of the cervix by different amounts of roentgen radiation: a comparison. Archives of Surgery. 1935 Oct 1;31(4):542-567.
  12. Graham RM. The effect of radiation on vaginal cells in cervical carcinoma; the prognostic significance. Surgery, gynecology & obstetrics. 1947 Feb;84(2):166-173.
  13. Shier CB. The prognosis of carcinoma of the cervix uteri by vaginal smear: A preliminary report. American journal of obstetrics and gynecology. 1954 Feb 28;67(2):286-292.
  14. Grossman MH, Lochte WP, Coulter Sr WW. Prognostic significance of the vaginal smear after irradiation of uterine carcinoma. Texas state journal of medicine. 1948 Dec;44(8):594-596.
  15. Umiker W, Lampe I, Rapp R, Latourette H, Boblitt D. Irradiation effects on malignant cells in smears from oral cancers. A preliminary report. Cancer. 1959 May 1;12(3):614-619.
  16. Silverman S, Sheline GE. Effects of radiation on exfoliated normal and malignant oral cells. A preliminary study. Cancer. 1961 May 1;(3):587-96.
  17. Silverman S, Sheline GE, Gillooly CJ. Radiation therapy and oral carcinoma. Radiation response and exfoliative cytology. Cancer. 1967 Aug 1;20(8):1297-1300.
  18. Wachtel EG. Radiation changes in vaginal smears. Exfoliative Cytology in Gynecological Practice. 1964:175-193.
  19. Bindu L, Balaram P, Mathew A, Remani P, Bhattathiri VN, Nair MK. Radiation-induced changes in oral carcinoma cells–a multiparametric evaluation. Cytopathology. 2003 Oct 1;14(5):287-293.
  20. Shield PW, Wright RG, Free K, Daunter B. The accuracy of cervicovaginal cytology in the detection of recurrent cervical carcinoma following radiotherapy. Gynecologic oncology. 1991 Jun 30;41(3):223-229.
  21. Cowpe JG, Longmore RB, Green MW. Quantitative exfoliative cytology of abnormal oral mucosal smears. Journal of the Royal Society of Medicine. 1988 Sep 1;81(9):509-513.
  22. Raj V, Mahajan S. Dose response relationship of nuclear changes with fractionated radiotherapy in assessing radiosensitivity of oral squamous cell carcinoma. Journal of Clinical and Experimental Dentistry. 2011;3(3):e193-200.
  23. Sankaranarayanan R, Ramadas K, Thomas G, Muwonge R, Thara S, Mathew B, et al. Effect of screening on oral cancer mortality in Kerala, India: A cluster-randomised controlled trial. Lancet 2005;365:1927-1933.
  24. Dikshit R, Gupta PC, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L, Badwe R, et al. Cancer mortality in India: A nationally representative survey. Lancet 2012;379:1807-1816.
  25. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v2.0, Cancer incidence and mortality worldwide: IARC Cancer Base No. 10. Lyon, France: International Agency for Research on Cancer; 2010.
  26. Prelec J, Laronde DM. Treatment modalities of oral cancer. Canadian Journal of Dental Hygiene. 2014 Feb;48(1):13-19.
  27. Mehrotra R, Singh M. Serial scrape smear cytology of radiation response in normal and malignant cells of oral cavity. Indian journal of pathology & microbiology. 2004 Oct;47(4): 497-502.
  28. Minhas S, Kashif M, Nagi AH. Evaluation of Various Nuclear Cytological Changes in Normal Buccal Mucosa and Peritumoural Area in Patients with Oral Squamous Cell Carcinoma Receiving Concomitant Chemoradiotherapy. Pathology research international. 2016 Apr;11;2016.
  29. Mehrotra R, Singh M. Serial scrape smear cytology of radiation response in normal and malignant cells of oral cavity. Indian journal of pathology & microbiology. 2004 Oct;47(4):497-502.
  30. Bhattathiri NV, Bindu L, Remani P, Chandralekha B, Nair KM. Radiation-induced acute immediate nuclear abnormalities in oral cancer cells. Acta cytologica. 1998 Jul 1;42(5):1084-1090.
  31. Bhattathiri NV, Bharathykkutty C, Prathapan R, Chirayathmanjiyil DA, Nair KM. Prediction of radiosensitivity of oral cancers by serial cytological assay of nuclear changes. Radiotherapy and oncology. 1998 Oct 31;49(1):61-65.
  32. Ogden GR, Cowpe JG, Green MW. Effect of radiotherapy on oral mucosa assessed by quantitative exfoliative cytology. Journal of clinical pathology. 1989 Sep 1;42(9):940-943.
  33. Mehrotra R, Goel N, Singh M, Kumar D. Radiation-related cytological changes in oral malignant cells. Indian journal of pathology & microbiology. 2004 Jul;47(3):343-347.
  34. Peters H. Cytologic smears from the mouth: Cellular changes in disease and after radiation. American journal of clinical pathology. 1958 Mar 1;29(3):219-225.
  35. Agarwal D, Khan N, Siddhiqu SA, Afroz N. Assessment of Various Cytological Changes For Predicting Radiosensitivity of Oral Cavity Cancer by Serial Cytology. JK Science 2011;13(4):171.
  36. Ahmed HG, Elemirri DA. Assessment of oral cytological changes associated with exposure to chemotherapy and/or radiotherapy. Cy to Journal. 2009 Jan 1;6(1):8.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.