Buccal Cell Micronuclei among Betel Quid Chewers and Non-Betel Quid Chewers from Selected Barangays in Zamboanga City

Benkassar Abdurajak, Servando Halili Jr., Al-Zamzam Abubakar

Abstract

Background. Betel quid chewing has been reported to have carcinogenic properties due to the presence of harmful compounds present in its ingredients. The oral mucosa is directly exposed to these carcinogenic compounds which could cause pathological changes and lead to malignancies. Micronucleus is a biomarker that indicates genetic alteration could form due to exposure from carcinogenic substances that can be attributed from betel quid chewing. Thus, a person’s oral health status can be gauged through the detection of micronucleus in buccal cells.

Objective. A cross-sectional study was done to compare the presence of micronuclei in buccal epithelial cells between betel quid chewers and non-betel quid chewers in Zamboanga City.

Methodology. Purposive sampling was used to enroll the 104 participants (52 betel quid chewers and 52 non-betel quid chewers). The demographic profiles and betel quid chewing habits of the participants were obtained using a questionnaire. Buccal cells samples were collected using clean and dry tongue depressors and were smeared directly onto pre-cleaned glass slides. Slides were processed for Papanicolaou staining by a medical technologist. For each slide, 1000 buccal cells were examined using a light microscope with an attached camera. Photomicrographs of buccal cells with micronuclei were taken. Two pathologists separately validated the results through the photomicrographs. Intraclass correlation coefficient for inter-rater reliability gave a value of 1 which indicates high reliability among observers.

Results. The median of the frequency of micronuclei among betel quid chewers and non-betel quid chewers were 56.5 and 36, respectively. Mann-Whitney U test revealed a significant difference (p=0.031) at α=0.05 in the Micronuclei frequency between the 2 groups. There were 36.5% of betel quid chewers who have Micronuclei frequency above the cut-off value and on the other hand, 15.4% among the non-betel quid chewers. Pearson’s correlation coefficient revealed that there was a very weak negative relationship (r=-0.072) between total Micronuclei frequency and length of time of betel quid exposure among the exposed group.

Conclusion. Betel-quid chewers have significantly higher frequency of micronuclei compared to non-betel quid chewers which puts them at higher risk for developing oral malignancies.

Keywords

micronucleus, betel, quid, Areca, Papanicolaou

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References

Davis GG. Buyo cheek cancer with special reference to etiology. JAMA. 1915; LXIV(9):711-8. https://doi.org/10.1001/jama.1915.02570350005002.

Stitch HF, Rosin MP, Vallejera MO. Reduction with vitamin A and beta-carotene administration of proportion of micronucleated buccal mucosa cells in Asian betal nut and tobacco chewers. Lancet. 1984;1(8388):1204-6. PMID: 6144923.

Nelson BS, Heischober B. Betel nut: a common drug used by naturalized citizens from India, Far East Asia, and the South Pacific Islands. Ann Emerg Med. 1999;34(2):238-43. PMID: 10424931.

Leghari MA, Ali S, Maqbool S. The prevalence of use of areca nut and its effect on oral health in school going children in Gadap town, Malir, Karachi, Pakistan. World J Dent. 2016;7(1):6-9.

Pindborg JJ. Epidemiological studies for oral cancer. Int Dent J. 1977;27(2);172-8. PMID: 267624.

Murti PR, Bhonsle RB, Gupta PC, Daftary DK, Pindborg JJ, Mehta FS. Etiology of oral submucous fibrosis with special reference to the role of areca nut chewing. J Oral Pathol Med. 1995;24(4):145-52. PMID: 7783003.

Adhikari A, De M. Toxic effects of betel quid. Int J Hum Genet. 2013;13(1):7-14.

Sabharwal R, Verma P, Syed MA, et al. Emergence of micronuclei as a genomic biomarker. Indian J Med Paediatr Oncol. 2015;36(4):212-8. PMID: 26811590. PMCID: PMC4711219. https://doi.org/10.4103/0971-5851.171541.

Jeng JH, Kuo ML, Hahn LJ, Kuo MYP. Genotoxic and no-genotoxic effects of betel quid ingredients on oral mucosal fibroblasts in vitro. J Dent Res. 1994;73(5):1043-9. PMID: 8006230. https://doi.org/10.1177/00220345940730050501.

Bhide SV, Padma PR, Amonkar AJ. Antimutagenic and anticarcinogenic effects of betel leaf extract against the tobacco-specific nitrosamine 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK). IARC Sci Publ. 1991;(105):520-4. PMID: 1855909.

Jois HS, Kale AD, Mohan Kumar KP. Micronucleus as potential biomarker of oral carcinogenesis. Indian Journal of Dental Advancements. 2010;2:1-5.

Celik A, Cavas T, Ergene-Gözükara S. Cytogenetic monitoring in petrol station attendants: micronucleus test in exfoliated buccal cells. Mutagenesis. 2003;18(5):417-21. PMID: 12960409.

Anila K, Hallikeri K, Naikmasur VG. Comparative study of oral micronucleated cell frequency in oral submucous fibrosis patients and healthy individuals. J Clin Exp Dent. 2011;3(3): e201-6. https://doi.org/10.4317/jced.3.e201.

Tolbert PE, Shy CM, Allen JW. Micronuclei and other nuclear anomalies in buccal smears: methods development. Mutat Res. 1992;27(1):69-77. PMID: 1371831.

Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009:45(4-5):309-16. PMID: 18804401. https://doi.org/10.1016/j.oraloncology.2008.06.002.

Fareed M, Afzal M, Siddique YH. Micronucleus investigation in buccal cells among pan masala/gutkha chewers and its relevance for oral cancer. Biol Med. 2011;3:8-15.

Nair U, Obe G, Nair J, et al. Evaluation of frequency of micronucleated oral mucosa cells as a marker for genotoxic damage in chewers of betel quid with or without tobacco. Mutat Res. 1991;261(3):163-8.

Stich HF, Stich W, Farida BB. Elevated frequency of micronucleated cells in the buccal mucosa of individuals at high risk for oral cancer: betel quid chewers. Cancer Lett. 1982;17(2):125-34. PMID: 6187434.

Suhas S, Ganapathy KS, Gayatri Devi, Ramesh C. Application of the micronucleus test to exfoliated epithelial cells from the oral cavity of beedi smokers, a high-risk group for oral cancer. Mutat Res. 2004;561(1-2):15-21. PMID: 15238226. https://doi.org/10.1016/j.mrgentox.2004.03.001.

Stich HF, Rosin MP. Quantitating the synergistic effect of smoking on alcohol consumption with the micronucleus test on human buccal mucosa cells. Int J Cancer. 1983;31(3):305-8. PMID: 6826255.

Reichart PA, Philipsen HP. Betel chewer’s mucosa-a review. J Oral Pathol Med. 1998; 27(6):239-42. PMID: 9707274.

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