Study of the Angle Between Axial and Digital Triradius of the Dermatoglyphics Trait Among Cancer Cervix Patients in Eastern Indian Population

e-ISSN: 0976-822X, p-ISSN:2961-6042 Available online on http://www.ijcpr.com/ International Journal of Current Pharmaceutical Review and Research 2025; 17(8); 509-513 Pramanik et al. International Journal of Current Pharmaceutical Review and Research 509 Original Research Article Study of the Angle Between Axial and Digital Triradius of the Dermatoglyphics Trait Among Cancer Cervix Patients in Eastern Indian Population Asutosh Pramanik1, Dona Saha2, Madhushree Pal3, Suchismita Ghosh4, Falguni Mondal5 1Assistant Professor, MBBS, MD Anatomy, Department of Anatomy, Barasat Government Medical College and Hospital, Kolkata, West Bengal 700124 2Associate Professor, MBBS, MD Anatomy, Department of Anatomy, Barasat Government Medical College and Hospital, Kolkata, West Bengal 700124 3Assistant Professor, MBBS, MD Anatomy, Department of Anatomy, Barasat Government Medical College and Hospital, Kolkata, West Bengal 700124 4Senior Resident, MBBS, MD Anatomy, Department of Anatomy, Barasat Government Medical College and Hospital, Kolkata, West Bengal 700124 5Sister Tutor, MSc Nursing, Department of Psychiatry, Nursing Training School (G. N. M), Berhampore, Murshidabad, West Bengal 742101 Received: 01-06-2025 / Revised: 16-07-2025 / Accepted: 13-08-2025 Corresponding Author: Dr. Madhushree Pal Conflict of interest: Nil Abstract Introduction: Dermatoglyphics is the study of epidermal ridge patterns on the fingers, palms, and soles. The correlation of dermatoglyphic patterns with many chromosomal abnormalities and genetic diseases is evidenced by many researchers in the world. As cervical cancer has strong genetic association, the dermatoglyphic pattern study can be useful as a screening method for early diagnosis and to find out the individuals at risk. Aims: To compare the angle between line drawn from axial triradius ‘t’ at base of palm between the thenar and hypothenar eminences to triradius ‘a’ (at base of index finger) and to triradius ‘d’ (at base of little finger) inbetween cervical cancer patient and control group. Materials and Method: This hospital based cross-sectional analytical study was conducted in different Medical Colleges & Hospital. Histopathologically confirmed seventy two cases of cervical carcinoma of above 15 years of age are considered as case & their first degree relatives were selected as control who are above 15 years of age. The axial and digital triradius in palmar print was measured by using Ink method. Result: A case-control study was done among seventy-two cases of histopathologically confirmed cervical cancer patient of above 15 years of age and their first-degree relatives as control group of 72 females of above 15 years of age. The palmar prints of both palms were collected by ink method and atd angle of each print was measured. Data were analyzed by taking mean and standard deviation and tested by student’s t-test, considering p-value<0.05 as statistically significant. Discussion: Statistically highly significant values are observed in the mean atd angle of the right hand of cervical cancer patient (40.07± 3.24) compared to control (44.57±6.39) and also left hand of cervical cancer patient (41.49± 4.07) compared to control (46.88±7.83). Conclusion: Increased atd angle of both hand has strong predilection for the development of cervical cancer. Key Words: Dermatoglyphics study, Axial triradius, Digital triradius, atd angle, cervical cancer, Ink method. This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided original work is properly credited. Introduction Cervical carcinoma is the fourth most common cancer among women worldwide, with an estimated 6, 61,021 new cases and 3, 48,189 deaths worldwide in 2022.[1] Wide variations in incidence and mortality from the disease exist between countries. Cases and deaths have declined markedly in the last few years as a result of extensive screening programs and advancement in treatment methods. Cervical cancer ranks in the top five cancers for both incidence and mortality in low and medium HDI (Human Development Index) regions and India. An estimated one million children became maternal orphans in 2020 because their mother died from cancer in that year, with close to one half of these orphans the result of maternal deaths from either female breast or cervical cancer.[1] International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 Pramanik et al. International Journal of Current Pharmaceutical Review and Research 510 Dermatoglyphics is the scientific study of epidermal ridges and their configurations on the palmar region of hand and fingers and plantar region of foot and toes. The ridge pattern depends upon the cornified layer of epidermis and dermal papillae. The typical patterns of epidermal ridges are determined since their formation in fetus. There is proliferation of cells in the lower zone of epidermis which projects into the dermis as a regularly spaced thickenings and the dermis subsequently projects upward in the epidermal hollows. This is followed by the appearance of elevations formed by them on the skin surface which gives rise to epidermal ridge.[2] Dermatoglyphics is the scientific study of epidermal ridges and their configurations on the palmar region of hand and fingers and plantar region of foot and toes. The term dermatoglyphics was coined by Cummins H and Midlo C2 in 1926 and was derived from Greek words ‘derma’ means skin and ‘glyphics’ means carvings [3]. Development of dermatoglyphic pattern is under genetic control. This is evident from the clear resemblance of dermatoglyphics among related person [4]. There are many diseases known to be caused by abnormal genes. Whenever there is any abnormality in the genetic makeup of parents it is inherited to the children and is reflected in dermatoglyphic pattern [5]. Dermatoglyphics as a diagnostic aid is now well established in a number of diseases, having strong hereditary basis, and also employed as a method of screening anomalies [6]. Dermatoglyphics has been studied extensively in chromosomal disorders & it proved quite useful in the medico-legal, anthropological & clinical fields. The cervical cancer is one of the most extensively studied cancers & its genetic basis was well established [7]. The screening procedures like Pap smear test have been effectively reducing the incidence rate by 80% and mortality by 70% but they are expensive and invasive procedures and also equipped set up is required [8]. The etiology of cervical carcinoma is multi-factorial with genetics playing an important role. Taking into consideration of genetic predisposition of dermatoglyphics and cervical carcinoma, the study was undertaken to find out correlation between them. Being inexpensive and non-invasive procedure dermatoglyphics may be useful screening procedures for the population at risk in cervical carcinoma. Materials & Method This hospital based cross-sectional analytical study was conducted in different Medical Colleges & Hospital during June 2014 to May 2021. Written consent was taken from every patient included in this study. The study was done after taking permission from the institutional ethical committee and review Board. Histopathologically confirmed seventy-two cases of cervical carcinoma of above 15 years of age are considered as case (Fig 1-3) & their first-degree relatives were selected as control who are above 15 years of age to see the genetic predisposition. Cervical cancer patient with no firstdegree relatives, very seriously ill patients, women having genetic disorder or skin hypersensitivity or ridge aplasia/hypoplasia were excluded from the study. Among the various methods of dermatoglyphics, this study was done by Ink Method (described by Cummins H in 19369 and Cummins H and Midlo C, 19612) for both palms. After taking proper consent and explaining the process, the subjects were asked to clean their hands with soaps and water. A small amount of Kores black duplicating ink was placed on the glass slab a thin even ink film was made by rubber roller. The area of the palm to be printed was pressed upon the slab gently. Then the inked area of the palm was place on slightly glazed good quality paper which was kept over the pressure pad. With the help of magnifying glass axial and digital triradius in palmar print of study subjects were identified. (Fig 4) Atd angle has been extensively used in dermatoglyphic examinations since it was originally introduced by Penrose in 194910.The triradius is formed by three ridge systems in the palm. The triradius is found at the base of each finger except the thumb and they are designated as a, b, c, d digital triradii in order from index to little finger. Another triradius is also found at the base of the palm between the thenar and hypoth¬enar eminences and it is known as axial triradius ‘t’. The angle between a line drawn from ‘t’ to ‘a’ and ‘t’ to ‘d’ is atd angle.[Fig: 1 ]. Atd angle is an indication of the degree of distal displacement of axial triradius; and the angle increases as the triradius is more distally located. Data was analyzed revealing mean and standard deviation and tested by two-tailed student’s t-test (independent). Differences were considered statistically significant if P values were less than 0.05. Figure 1: Keratin pearls surrounded by malignant cervical squamous cells in 40X magnification International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 Pramanik et al. International Journal of Current Pharmaceutical Review and Research 511 Figure 2: Nests & cords of keraninised malignant cervical squamous cells in 40X magnification Figure 3: Nests of malignant squamous cells with underlying stromal invasion in carcinoma cervix in 40X magnification Figure 4: Measurement of atd angle in both palm Results and Analysis: In the present study after taking fingerprints of both hands of all 144 (72 cases and 72 controls) females, following observations were made. Table 1: Age wise distribution of cervical cancer patients and control group Age group in years Patients Controls Frequency Percentage Frequency Percentage 16-20 2 2.78 5 6.94 21-25 1 1.39 6 8.32 26-30 13 18.06 14 19.45 31-35 10 13.89 10 13.89 36-40 16 22.22 13 18.06 41-45 13 18.06 8 11.11 46-50 14 19.44 11 15.28 >51 3 4.16 5 6.95 Total 72 100 72 100 Table 1 shows mean age of the cervical cancer patients and control group were 38.19 and 36.07 respectively. International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 Pramanik et al. International Journal of Current Pharmaceutical Review and Research 512 Table 2: Statistical analysis for atd angle (degree) among patients (n1=72) & controls (n2=72) Groups atd angle(degree) Right hand(mean±SD) Left hand(mean±SD) Patients 40.07±3.24 41.49±4.07 Controls 44.57±6.39 46.88±7.83 t value 5.090 5.183 P value <0.001 <0.001 Remarks ES ES Table 2 shows that, cancer cervix patients show significantly lower mean atd angle (degree) as compared to controls in right hand and left hand, the differences are highly statistically significant. Discussion Dermatoglyphics as a diagnostic tool is now well established in a number of diseases which have strong hereditary basis. Cervical carcinoma being the hereditary background, certain dermatoglyphic variations were to be expected in it. The mean age of carcinoma cervix females was 38.194 years. In this study there is decrease in mean atd angle in cervical cancer patients which was found to be 40.07±3.24compared to control group of 44.57±6.39in case of right palm and 41.49±4.07 in left palm compared to 46.88±7.83 for control group. This finding was almost similar to the findings by Wattamwar PP [11] in North Indiain populaton having atd angle of 38.8±3.8 (control 47.4±6.4) and 38.8+4.4(control 47.3±6.3) for right and left palm respectively. Our study revealed highly significant association between atd angle and carcinoma cervix which corresponds with similar study done in Uttarpradesh, India by K Pravallika[12] who found that atd angle for right palm was 44.92±2.91 and for left palm was 43.84±3.70. However, in contrary to our study, the atd angle was found to be increased in both studies done by Patil [13] in western part of India & by Gahlot [14] in North Indian population. Variations in ATD angle not only related to cervical cancer but also related to other genetic diseases and cancers. ATD angle was statistically significantly higher in both palm in patients with breast cancer seen in the study of Johri V [15], and Rawat [16] & Ganesh done on Indian population & also in the study of Metovic A [17] done on BosnianHerzegovinian population. In the study of Olidipo G.S [18] it was observed that prostate cancer patients had significantly lower mean ATD angle than the normal subjects. Studies done in India showed the atd angle was larger among type 2 Diabetes Mellitus patients as compared to normal individuals.[19-21] This cross-sectional study included 300 uterine-cervix cancer patients aged between 21-60 years (mean=45.66 years). Predominant age group affected was 41-50 years, followed by 51-60 years and 3140 years. Minimal incidence was seen in 21-30 years age group. This cross-sectional study included 300 uterine-cervix cancer patients aged between 21-60 years (mean=45.66 years). Predominant age group affected was 41-50 years, followed by 51-60 years and 3140 years. Minimal incidence was seen in 2130 years age group Limitations of the study Considering all parameters of dermatoglyphic trait of both palm and sole rather than only atd angle would have rendered better results. Including subjects from different geographical populations and different ethnicities might increase our sample size and produce more appropriate data. Though data collection is quick, simple, non-invasive, inexpensive and readily accessible, but increase in size of hand with age results in alteration of atd angle. The main limitation of the study was smaller sample size with regional specificity. Some potential error in measurement or subjective variations may occur during the measurement by different examiner. Future Scope In future, this type of study can be done by considering larger sample size in different geographical area along with other dermatoglyphics parameters. To exclude observer bias, machine learning can be done for pattern recognition which will render more accurate readings. Acknowledgment We thank all the patients and their families included in the study and especially grateful to the department of Pathology and department of Gynaecology & Obstetrics of different medical colleges for their support. Bibliography 1. Cervical cancer. Knowledge-action-portal.com [Internet]. 2024 Sep 3 [cited 2024 Sep 3]. Available from: https://www.knowledgeaction-portal.com/en/content/cervical-cancer. 2. Cummins H, Midlo C. Finger prints of palms and soles: An introduction to dermatoglyphics. New York: Dovar Pub. Inc.; 1961. 3. Penrose LS. Finger prints, palms and chromosomes. J Nature. 1963;197:933–938. 4. Schaumann B, Alter M. Dermatoglyphics in medical disorders. New York: Springer Verlag; 1976. p. 187–189. 5. Walker JFA. Sex-linked recessive finger print pattern. J Hered. 1941;32:279–280. International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 Pramanik et al. International Journal of Current Pharmaceutical Review and Research 513 6. Holt SB. Dermatoglyphic patterns: Genetical variation in human population. Oxford: Pergamon Press; 1961. p. 791. 7. National Cancer Institute. HPV damage, genes, chromosomes [Internet]. Available from: http://www.cancer.gov/newscenter/caccerrese archnews/2013/HPV/Damage/Genes/Chromos omes/Annual [last accessed May 26, 2015]. 8. Konar H. DC Dutta’s Textbook of Gynecology including contraception. 6th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2013. p. 110–116. 9. Cummins H. Dermatoglyphic stigmata in Mongolism. Anat Rec. 1936;64(suppl. 2):11. 10. Berg JM. The study of the dermal ridge count on the human palm. Hum Biol. 1968;40:375– 385. 11. Wattamwar PP, Hosmani PB. Study of dermatoglyphics in carcinoma cervix. Int J Anat Res. 2016;4(2):2349–2353. 12. Pravallika K, Tewari V, Sharma S, Kumar A. Correlation of dermatoglyphics with clinical characteristics of cervix carcinoma patients at a tertiary care centre in Kanpur, Uttar Pradesh, India. J Clin Diagn Res. 2022;16(03):234–239. 13. Patil KV, Kulkarni PR, Diwan CV. Study of dermatoglyphics in the occurrence of carcinoma of cervix. Int J Recent Trends Sci Technol. 2015;14(03):653–655. 14. Gahlot R, Yadav P, Saxena M, Pahuja K, Singh J. Geographical variation in Atd angle of breast and cervix cancer patients in Rajasthan and Punjab State. J Cardiovasc Dis Res. 2022; 13(01): 506–516. 15. Johri V, Raizada A, Takiar R. Evaluation of palmar angles in carcinoma breast patients and in normal healthy females. Int J Anat Radiol Surg. 2020;9(1):AO01–AO03. 16. Rawat A, Ganesh N. Novel tumor markers of breast cancer. 19th Congress of the European Society for Sexual Medicine; 2017; Nice, France. 17. Metovic A, Musanovic J, Alicelebic S, Pepic E, Sljuka S, Mulic M. Predictive analysis of palmar dermatoglyphics in patients with breast cancer for small Bosnian-Herzegovinian population. Med Arch. 2018 Nov;72(5):357– 361. 18. Oladipo GS, Sapira MK, Ekeke ON, Oyakhire M, Chinwo E, Apiafa B, et al. Dermatoglyphics of prostate cancer patients. Curr Res J Biol Sci. 2009;1(3):131–134. 19. Shrestha S, Mansur D, Tamrakar R, Shrestha P, Maskey S. Mean Atd angle among type 2 diabetes mellitus patients visiting a tertiary care centre: a descriptive cross-sectional study. J Nepal Med Assoc. 2023 Feb 28;61(258):141– 144. 20. Srivatsava S, Burli S. A study of palmar dermatoglyphics in type 2 diabetes mellitus in a Bangalore-based population. Indian J Clin Anat Physiol. 2019;6(1):118–125. 21. Gautam M, Singh UP. Palmar dermatoglyphics of the Khatiks and Kumbhars of Lucknow, Uttar Pradesh. Asian Man (The) - An Int J. 2017 Jan;11(1):58.