Alterações citológicas relacionadas à mucosite oral em pacientes oncopediátricos: análise citomorfométrica de quatro casos

Abstract

Exfoliative cytology allows the analysis of quantitative parameters through the cytomorphometry, contributing to the knowledge of the pathogenesis of many lesions. The aim of this study was to evaluate the cytological alterations in oral mucosa smears from 4 pediatric patients undergoing chemotherapeutic treatment. Smears were collected by exfoliative cytology at the baseline and weekly, with a 7 day interval between the collections, until the development of mucositis. Smears were stained using the Papanicolaou method and analyzed under a light microscope. Fifty epithelial cells were photomicrographed (x400) and the images obtained were submitted to cytomorphometric analysis. Nuclear area (NA), cytoplasmic area (CA) and nucleus-to-cytoplasm area ratio (NA/CA) were evaluated with ImageJ® software. In the reported cases, it was verified that the mean CA as well as the NA decreased from the baseline to the final measurements taken in the time period before the manifestation of the oral mucositis, except in case 2 in which the NA increased. That changed when the NA/CA ratio was compared, for the values decreased for cases 1 and 4, increased for case 2 and was not altered for case 3. Oncopediatric patients undergoing chemotherapeutic treatment revealed cytological alterations in oral mucosal epithelial cells, specially the reduction in CA. These findings highlight the importance of further cohort studies with larger samples to evaluate the potential of these cytological alterations as predictors of the development of oral mucositis and, therefore, allow the execution of early interventions that minimize or prevent its development.