European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Role of nutritional (PNI, CONUT) and inflammatory indices (SII) in predicting lymph node metastasis and prognosis of thyroid cancer: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Liu Yi, Xiao Rong
Аннотация
PURPOSE: Markers reflecting systemic inflammation and nutritional condition are now often applied in predicting cancer outcomes, yet their role in thyroid malignancies has not been clearly established. We reviewed the evidence in the literature on the role of Prognostic Nutritional Index (PNI), Controlling Nutritional Status Score (CONUT), and Systemic Immune-Inflammation Index (SII) in predicting lymph node metastasis (LNM), overall survival (OS), and disease-free survival (DFS) in thyroid cancer.
METHODS: Two reviewers searched CENTRAL, Embase, PubMed, and Scopus databases till 24th August 2025 for relevant publications. A random-effects meta-analysis was conducted.
RESULTS: Thirteen studies were eligible. Combined results demonstrated that elevated SII was slightly but significantly correlated with increased risk of LNM (HR: 1.00; 95% CI: 1.00-1.01; I² = 93%). Results failed to change in the sensitivity analysis. Subgroup analysis based on location and histology indicated non-significant results while meta-regression did not identify any significant moderators. Pooled analysis indicated no significant association between low PNI and DFS (HR: 1.45 95% CI: 0.97, 2.18 I2 = 80%) and LNM (HR: 1.31 95% CI: 0.89, 1.92 I2 = 73%) in thyroid cancer patients. Meta-analysis also showed that high CONUT was associated with a tendency of worse DFS in thyroid cancer, but results were non-significant (HR: 3.25 95% CI: 0.99, 10.69 I2 = 86%). However, meta-analysis showed that high CONUT was significantly associated with worse OS (HR: 9.67 95% CI: 1.90, 49.25 I2 = 61%).
CONCLUSIONS: Limited data suggest that high SII may be marginally associated with increased risk of LNM in thyroid cancer, the clinical significance of which is questionable. PNI was not found to be associated with LNM or DFS in thyroid cancer patients. High CONUT was associated with poor OS and a non-significant tendency for worse DFS in thyroid cancer.
METHODS: Two reviewers searched CENTRAL, Embase, PubMed, and Scopus databases till 24th August 2025 for relevant publications. A random-effects meta-analysis was conducted.
RESULTS: Thirteen studies were eligible. Combined results demonstrated that elevated SII was slightly but significantly correlated with increased risk of LNM (HR: 1.00; 95% CI: 1.00-1.01; I² = 93%). Results failed to change in the sensitivity analysis. Subgroup analysis based on location and histology indicated non-significant results while meta-regression did not identify any significant moderators. Pooled analysis indicated no significant association between low PNI and DFS (HR: 1.45 95% CI: 0.97, 2.18 I2 = 80%) and LNM (HR: 1.31 95% CI: 0.89, 1.92 I2 = 73%) in thyroid cancer patients. Meta-analysis also showed that high CONUT was associated with a tendency of worse DFS in thyroid cancer, but results were non-significant (HR: 3.25 95% CI: 0.99, 10.69 I2 = 86%). However, meta-analysis showed that high CONUT was significantly associated with worse OS (HR: 9.67 95% CI: 1.90, 49.25 I2 = 61%).
CONCLUSIONS: Limited data suggest that high SII may be marginally associated with increased risk of LNM in thyroid cancer, the clinical significance of which is questionable. PNI was not found to be associated with LNM or DFS in thyroid cancer patients. High CONUT was associated with poor OS and a non-significant tendency for worse DFS in thyroid cancer.