Redefining epithelial characterization in oral submucous fibrosis using morphometric analysis

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic oral mucosal disease characterized by progressive deposition of collagen in subepithelial connective tissue and epithelial atrophy. The present study was conducted to evaluate the changes in epithelial thickness and cellular and nuclear morphometric characteristics of parabasal and spinous compartments of the epithelium in various stages of OSMF in comparison to normal epithelium. MATERIALS AND METHODS: Sample included 30 cases of OSMF of various stages and five cases of normal buccal mucosa. Measurements for epithelial thickness and cellular morphology using morphometric analysis were performed on captured digital images using image analysis software. STATISTICAL ANALYSIS: The ANOVA analysis of epithelial thickness and correlation of epithelial thickness with cell contour and cell roundness was done using Karl Pearson's coefficient of correlation. RESULTS: There was a statistically significant decrease in epithelial thickness with increase in severity/stage of OSMF. It was also observed that there is a highly statistically significant correlation (P = 0.000) between the thickness of epithelium and cell morphology in varying stages of OSMF. CONCLUSION: The morphometric parameters and the use of quantitative histological methods in determining the squamous epithelial structures thus made it possible to evaluate that there is reduction in thickness of epithelium or “atrophy” with increasing stages of OSMF which may be due to actual change in cell morphology of the individual cells of specific compartment or all compartments in the epithelium.