Systemic immune inflammation index in patients with recurrent aphthous stomatitis

Abstract Objectives: Recurrent Aphthous Stomatitis (RAS) a chronic idiopathic oral mucosal disease. But yet the etiology and pathogenesis of RAS are not exactly known, it is thought that inflammation play an important role in the pathogenesis. The aim of this study is to demonstrate the role of systemic inflammation among the possible etiological factors of RAS and to find the possible diagnostic correlation between Systemic Immune Inflammation Index (SII). Methods: Patients who were consulted the otolaryngology outpatient clinic and diagnosed with RAS between 2019–2021 were retrospectively analyzed. Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) and SII values were calculated based on the results of complete blood count. Demographic and hematological parameters between control and RAS groups were compared. The statistical significance level was considered as <0.05. Results: There was no statistically significant difference between the control and RAS groups in terms of sex and age distributions (p = 0.566 and p = 0.173, respectively). SII, NLR and PLR values were significantly higher in the RAS group compared to the controls (p < 0.001, p < 0.001 and p = 0.001, respectively). A very strong correlation between SII and NLR, moderately strong correlation between SII and PLR and moderate correlation between NLR and PLR values were detected (respectively ρ: 0.813, 0.719, 0.532; p-values <0.001). Conclusion: SII, NLR and PLR has significantly higher levels in the RAS group compared to the control group, that it supports the role of systemic inflammation in the etiopathogenesis of RAS. In addition, the results show that SII is a valuable marker for inflammation. Level of evidence: 4. HIGHLIGHTS RAS is a chronic, idiopathic, ulcerative oral mucosal disease. SII is a new and inexpensive biomarker that can easily be calculated using the platelet, neutrophil, and lymphocyte count. SII may be a valuable marker to demonstrate the role of systemic inflammation in RAS etiopathogenesis. Vascular, thrombotic, and inflammatory processes are thought to have a role in RAS activation.

摘要
目的：复发性阿弗他口炎（Recurrent Aphthous Stomatitis, RAS）是一种慢性特发性口腔黏膜疾病，但其病因及发病机制尚未完全明确，现有研究认为炎症在其发病过程中发挥重要作用。本研究旨在明确全身炎症在RAS潜在病因中的作用，并探讨全身免疫炎症指数（Systemic Immune Inflammation Index, SII）与RAS的潜在诊断相关性。
方法：对2019-2021年于耳鼻喉科门诊就诊并确诊为RAS的患者进行回顾性分析。根据全血细胞计数结果计算中性粒细胞/淋巴细胞比值（Neutrophil/Lymphocyte Ratio, NLR）、血小板/淋巴细胞比值（Platelet/Lymphocyte Ratio, PLR）及SII值。比较对照组与RAS组的人口学及血液学参数，统计学显著性阈值设定为P<0.05。
结果：对照组与RAS组在性别及年龄分布上无统计学差异（分别为P=0.566、P=0.173）。RAS组的SII、NLR及PLR值均显著高于对照组（分别为P<0.001、P<0.001、P=0.001）。检测发现SII与NLR间呈极强相关，SII与PLR间呈较强相关，NLR与PLR间呈中度相关（相关系数ρ分别为0.813、0.719、0.532；所有P值均<0.001）。
结论：与对照组相比，RAS组的SII、NLR及PLR水平显著升高，这支持了全身炎症在RAS发病机制中的作用。此外，本研究结果表明SII是一项具有临床价值的炎症标志物。证据等级：4级。
研究亮点：1. RAS是一种慢性、特发性、溃疡性口腔黏膜疾病；2. SII是一种新型且低成本的生物标志物，可通过血小板、中性粒细胞及淋巴细胞计数轻松计算得到；3. SII或可作为明确全身炎症在RAS发病机制中作用的可靠标志物；4. 血管、血栓形成及炎症过程被认为与RAS的激活相关。