Exfoliative Cytology of Oral Mucosa Epithelium: Cytochemical Study and Morphologic Analysis of Patients with Type 2 Diabetes

Background: Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia. An association between diabetes mellitus and periodontal disease has been reported. However, few comprehensive reports have examined the impact of chronic hyperglycemia on oral mucosal epithelial cells. This study clarified the effect of diabetes on oral mucosal epithelium cells. Methods: Cells from 44 patients with type 2 diabetes and 10 healthy controls were collected from the buccal mucosa, gingiva, and lateral margin of the tongue by exfoliation. Samples were subjected to Papanicolaou staining; immunochemical staining using anti-AGE antibody, anti-Ki-67 antibody, and anti-p53 antibody; and lectin chemical staining. Furthermore, the nuclear area and cytoplasmic area were measured, and the nuclear/cytoplasm ratio was calculated. Results: A chromatin condensation-like substance was found in samples from some diabetic patients. In AGE staining, positive cells were found in both groups, although the rate of positive cells tended to be higher in diabetic patients. No positive findings were found for Ki-67 and p53 antibodies. PNA and RCA120 showed differences in staining between diabetic patients and controls. The nuclear area was significantly expanded in diabetic patients (P Conclusion: These findings suggest that in patients with persistent hyperglycemia, changes in the sugar chain terminal of the cell surface may influence mucosal epithelial cell differentiation. The appearance of chromatin-like substances may be an indicator of the need for better management of type 2 diabetes.