Platelet-to-lymphocyte ratio and mean platelet volume in recurrent aphthous stomatitis: Systematic review and...

Haematological parameters are frequently employed to predict the clinicalcourse and prognosis of Recurrent aphthous stomatitis (RAS). This systematic review andmeta-analysis synthesise evidence regarding whether platelet-to-lymphocyte ratio (PLR) andmean platelet volume (MPV) differ significantly between individuals with RAS and healthycontrols.

Relevant publications were identified through searches of PubMed, Embase,Scopus, EBSCOhost, and Web of Science. Results are reported as standardised meandifferences (SMDs) with 95% confidence intervals (CIs). A random-effects model wasapplied to address significant heterogeneity affecting pooled effect size interpretation. Risk ofbias was assessed using the Newcastle-Ottawa Scale, and evidence quality was evaluatedwith the GRADE approach.

A total of seventeen articles reporting MPV and PLR data were included in themeta-analysis to assess differences between RAS patients and healthy controls. MPV washigher in RAS patients (SMD = 0.42; 95% CI: -0.53 to 1.36), although substantialheterogeneity was observed. Recomputed MPV was only marginally higher in RAS patients(SMD = 0.01; 95% CI: -0.31 to 0.32). The study population was the only significantmoderator of the pooled effect size. PLR values were also only slightly higher in RASpatients (SMD = 0.04; 95% CI: -0.06 to 0.14), with low to moderate heterogeneity. GRADEevidence quality was rated very low for computed MPV and low for PLR. A meta-analysisdemonstrates no significant difference in mean platelet volume or platelet-lymphocyte ratiobetween RAS patients and healthy controls, underscoring the imperative to identify othersystemic factors in RAS pathogenesis.