Detection of Barr bodies in exfoliated oral mucosal cells for sex determination using oral rinse-based cytology: A cross-sectional study

Abstract

Background: Sex determination is essential in forensic science, anthropology, and medical diagnostics. Traditional methods, such as DNA analysis, are resource intensive and time-consuming. This pilot study explores the utility of oral rinse-based cytology for detecting Barr bodies in exfoliated oral mucosal cells from saliva as a more accessible and efficient alternative. Aim: This study aimed to assess the viability of rinse-based cytology in identifying sex through the detection of Barr bodies. Materials and Methods: In the study, 60 participants aged 20–30, free of lesions, and nonsmokers/nondrinkers, were evenly divided into male and female groups. Unstimulated saliva was collected from each participant between 9 and 10 am Participants were instructed to tilt their heads slightly forward to accumulate saliva and then spit into disposable sterile containers. After centrifugation, two smears were prepared and stained with Papanicolaou (PAP) and hematoxylin and eosin (H and E) stains. The smears were labeled (single-blinded) and examined for the presence of Barr body by two oral pathologists. Results: H and E stain had a mean Barr body count of 2.38 and a standard deviation of approximately 2.731, whereas PAP stain had a higher mean count of 3.57 with a standard deviation of 3.933. Levene’s test showed significant differences (P = 0.000) in variances between the staining methods (F = 21.001, df = 118, P < 0.001), but the average Barr body count difference of about 1.183 with P = 0.058 was not statistically significant (P > 0.05). Conclusion: Oral rinse-based cytology offers a noninvasive, cost-effective, and time-efficient approach to sex determination. While this pilot study demonstrates its potential, further research involving larger and more diverse populations is required to validate its reliability fully. This innovative approach has the potential to impact various scientific and forensic disciplines, offering a practical alternative to traditional methods.