The correlation of systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with disease severity in recurrent aphthous stomatitis.

Abstract

To evaluate the correlation of systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) with disease severity in recurrent aphthous stomatitis (RAS). The present retrospective cohort study was performed on patients with RAS. Patients were divided into three groups: 1) Major (n=75), 2) Minor (n=123), and 3) Herpetiform aphthae (n=17). The study groups were compared in terms of demographic features, acute phase proteins, and complete blood cell count parameters. Moreover, correlation analyses were performed for the correlation of ulcer severity score (USS) with C-reactive protein (CRP), SII, erythrocyte sedimentation rate (ESR), ferritin, dNLR, NLR, and PLR. Significantly higher values were observed for USS, neutrophil count, ferritin, SII, NLR, and dNLR (p<0.05 for all) in the major and herpetiform aphthae groups compared to the minor aphthae group. Positive, strong, significant correlations were observed between USS, SII, and NLR (r=0.80 for SII, r=0.74 for NLR and p<0.001 for both). Positive, moderate, significant correlations were observed between USS, PLR, ESR, and CRP (r=0.54 for PLR, r=0.39 for ESR, r=0.36 for CRP, and p<0.001 for all). Positive, weak, significant correlations were observed between USS, dNLR, and ferritin (r=0.13 and p=0.05 for ferritin, r=0.27 and p<0.001 for dNLR). Higher values of SII, NLR, dNLR, and PLR were associated with disease severity in patients with RAS.