Evaluation of Platelet/Lymphocyte Ratio, Neutrophil/Lymphocyte Ratio, and platelet parameters in patients with Carpal Tunnel Syndrome

Abstract

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy, with inflammation suggested as a possible contributing factor in its pathogenesis. This study aimed to investigate the relationship between the severity of CTS and inflammatory blood markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). A total of 246 participants were included, comprising 150 patients diagnosed with CTS based on clinical and electrophysiological findings, and 96 healthy controls. Patients were classified as having mild, moderate, or severe CTS according to Padua's electrophysiological criteria. Complete blood counts were obtained after fasting, platelet parameters, NLR and PLR were calculated. Statistical analyses were conducted to compare hematological parameters between CTS patients and controls, and among CTS severity subgroups. No significant differences were found between CTS patients and controls in terms of neutrophil, lymphocyte, platelet counts, NLR, PLR, MPV, or PDW values (p>0.05). Similarly, subgroup analyses revealed no significant variation in these parameters across CTS severity levels. Correlation analysis showed a weak negative correlation between CTS severity and neutrophil count (r=-0.232, p=0.004), and NLR (r=-0.199, p=0.015). NLR was positively correlated with neutrophil count and PLR, and negatively with lymphocyte count. The findings suggest that NLR, PLR, and MPV may not be reliable markers of systemic inflammation in CTS population or its severity. Local inflammation may not always reflect systemic inflammatory status, and non-inflammatory mechanisms such as fibrosis might also play a role in CTS pathogenesis.