Method: Oral smears were collected from clinically normal-appearing mucosa by liquid-based exfoliative cytology in twenty SCA children (SCA group) and 20 healthy children (C group), matched for age and gender. The slides were prepared and stained by the Papanicolaou technique. Cell morphology and cellularity were analyzed and compared by Chi-square test (P <0.05). Images of 50 cells per slide were captured and the nuclear area (NA) and cytoplasmic area (CA) were analyzed using an image analysis system. The nucleous-to-cytoplasmic area ratio (NA/CA) was calculated. To compare the means of groups SCA and C, the Student t test (P<0.05) was applied to NA and CA; test non-parametric Mann-Whitney U (P <0.05) was used to NA/CA.
Result: Mean values for SCA and C groups were, respectively: NA (69.38µm² and 59.63 µm²; P=0.01); CA (2321.85 µm² and 2185.60 µm²; P=0.24); NA/CA (0.03 and 0.02; P=0.13). A significant increase in NA for SCA group (P=0.01) was showed. No morphological differences were found between the groups. There was a predominance of nucleated cells of the superficial layer in the smears of both groups. Class I smears were predominant in both groups.
Conclusion: This study revealed that sickle cell anemia was able to induce significant changes on nuclear area of the oral epithelial cells.