Microplication patterns on human buccal epithelia following radiotherapy: a scanning electron microscopic analysis.

Surface topographical detail in human buccal smears of normal and irradiated tissue have been studied with scanning electron microscopy. Cells collected by buccal smearing show patterns of microplicae and microvilli, although such detail is occasionally masked by mucus and to a lesser extent by debris and bacteria. Buccal smearing permits collection of numerous specimens with little discomfort to the patient, but requires caution in identification of superficial and deep cell layers and of upper and lower surfaces. The analysis of specimens derived in this way shows that variations in the pattern of surface microplicae reflect the radiotherapeutic regimes of the patients from which they were obtained. Straight parallel microplicae characteristic of normal control and pre-irradiated specimens were absent in specimens collected during early irradiation treatments (between 24-48 Gy), but instead were present as short discontinuous ridges and microvillous projections. At the highest levels of radiation treatment (54-60 Gy) cells exhibited small areas devoid of any surface projections in addition to a range of normal and early irradiated microplicae patterns. From these results it is suggested that the patterns of microplications and microvilli on cell surfaces can be used to obtain information on the state of the stratified squamous epithelium from which they come.