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Higher Remnant Cholesterol Inflammatory Index is Associated with Mortality in Patients with Lung Cancer: A UK Biobank Prospective Cohort Study with a Supportive External Cohort

Year: 2026

Type: article

Abstract: Background: We evaluated the association between the remnant cholesterol inflammatory index (RCII) and all-cause mortality (ACM) and lung cancer-specific mortality (LCM) among patients with lung cancer, and explored indirect associations through circulating immune-inflammatory indicators. Methods: The primary analysis included 4,128 UK Biobank participants with incident lung cancer, and the supportive external cohort included 452 pathologically confirmed patients from Longyan First Hospital. Cox proportional hazards models, Kaplan-Meier analyses, restricted cubic splines, interval-based sensitivity analyses, and a Fine-Gray competing-risk model for LCM were used. Neutrophil count, leukocyte count, red blood cell distribution width-coefficient of variation (RDW-CV), neutrophil-to-lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) were examined in separate exploratory single-mediator models. Results: During a median follow-up of 7.0 years in the UK Biobank cohort, 3,130 all-cause deaths and 2,563 lung cancer-specific deaths occurred. After full adjustment, each 1-standard deviation increase in RCII was associated with a 6% higher hazard of ACM (HR, 1.06; 95% CI, 1.02-1.10) and a 5% higher hazard of LCM (HR, 1.05; 95% CI, 1.01-1.09). Relative to the lowest quartile, the highest RCII quartile was associated with 19% and 16% higher hazards of ACM (HR, 1.19; 95% CI, 1.07-1.32) and LCM (HR, 1.16; 95% CI, 1.03-1.30), respectively. In the supportive external cohort, the fully adjusted HRs per 1-standard deviation increase were 1.41 (95% CI, 1.08-1.82) for ACM and 1.52 (95% CI, 1.17-1.98) for LCM. Exploratory analyses identified significant statistical indirect effects through neutrophil and leukocyte counts for both outcomes, whereas indirect effects through RDW-CV, NLR, and SIRI were significant only for ACM. Conclusion: Higher RCII was associated with higher hazards of ACM and LCM after lung cancer diagnosis, with directionally similar findings in the supportive external cohort. RCII represents an integrated host metabolic-inflammatory marker relevant to lung cancer prognosis and warrants further evaluation in prospective, clinically characterized cohorts.

Source: Journal of Inflammation Research

DOI: 10.2147/jir.s644334

Authors: Hongjin Wang, Jiehuan Lin, Pengtao Huang, Guobing Xu

Institutions: Fujian Medical University, Union Hospital

Language: English

Topic: Inflammatory Biomarkers in Disease Prognosis

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836