Diagnostic Significance of Neutrophil to Lymphocyte Ratio in Recurrent Aphthous Stomatitis: A Systematic Review and Meta-Analysis

Mohammad Javad  Rahimi; Fariba  Mirakhori; Rebecca  Zelmanovich; Christina  Sedaros; Brandon  Lucke-Wold; Gersham  Rainone; Arshin  Ghaedi; Shokoufeh Khanzadeh

doi:10.5826/dpc.1401a46

Diagnostic Significance of Neutrophil to Lymphocyte Ratio in Recurrent Aphthous Stomatitis: A Systematic Review and Meta-Analysis

Authors

Mohammad Javad Rahimi Department of Pediatric Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
Fariba Mirakhori Zanjan University of Medical Science, Zanjan, Iran
Rebecca Zelmanovich University of Central Florida, Orlando, USA
Christina Sedaros University of Florida, Gainesville, USA
Brandon Lucke-Wold Department of Neurosurgery, University of Florida, Gainesville, USA
Gersham Rainone Drexel University College of Medicine, USA
Arshin Ghaedi Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Shokoufeh Khanzadeh Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

Keywords:

NLR, Recurrent aphthous stomatitis, Meta-analysis, Neutrophil to lymphocyte ratio, inflammation

Abstract

Introduction: Recurrent aphthous stomatitis (RAS) is a prevalent ulcerative condition affecting oral mucosa.

Objectives: A systematic review and meta-analysis was performed to compare the level of neutrophil to lymphocyte ratio (NLR) between individuals with RAS and those who are healthy.

Methods: A systematic search for relevant publications before June 21, 2022, was conducted using Web of Science, PubMed, and Scopus. The results were presented as the standardized mean difference (SMD) with a 95% confidence interval (CI), and a random-effects model was used to calculate pooled effects due to the presence of significant heterogeneity. Quality assessment was performed using the Newcastle-Ottawa scale.

Results: Overall, 13 article with were included in the analysis. NLR was higher among patients with RAS compared to healthy controls (SMD = 0.50, 95% CI = -0.20 to 0.79, P = 0.001, I²= 91.5%). In the subgroup analysis based on the study design, it was found that retrospective studies showed higher levels of NLR in patients with RAS compared to healthy controls (SMD = 0.62, 95% CI= 0.16 to 1.08, P < 0.01), but these results were not applied to prospective studies (SMD = 0.35, 95% CI = -0.03 to 0.74, P < 0.07).

Conclusion: Elevated neutrophil to lymphocyte ratio revealed crosstalk between systematic inflammation and RAS.

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