Home›Oncology› Elevated inflammation-immunity-nutrition score linked to 2.13-fold higher mortality risk in cancer
Elevated inflammation-immunity-nutrition score linked to 2.13-fold higher mortality risk in cancerHigh Inflammation and Nutrition Scores Linked to Poorer Cancer Survival
Annals of medicinePublished August 21, 2026Study authors: He Kaixiang, Li Yunfei, Luo Jing, Luo YuhaoPubMed ↗DOI ↗Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development
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Key Takeaway
Consider IINS as a prognostic marker, but await prospective multiethnic validation before clinical use.
This meta-analysis synthesized data from 11 non-overlapping analytic cohorts comprising 3,950 unique participants, all from Chinese populations. The primary outcome was overall survival (OS), with progression-free survival (PFS) as a secondary outcome. The exposure was the inflammation-immunity-nutrition score (IINS), which integrates high-sensitivity C-reactive protein, lymphocyte count, and albumin.
Elevated IINS was significantly associated with poorer OS (HR = 2.13, 95% CI: 1.56-2.90, p < 0.001) and shorter PFS (HR = 1.95, 95% CI: 1.65-2.31, p < 0.001). These associations were consistent across the included cohorts.
The authors note that the evidence is predominantly retrospective and entirely derived from Chinese populations, which limits generalizability to other ethnicities. The analysis was based on binary comparisons (low vs. high IINS), and absolute numbers were not reported.
No adverse events or safety data were reported in this meta-analysis. The authors suggest that IINS may serve as an accessible prognostic marker in cancer, but they emphasize the need for prospective, multi-centre, multiethnic validation and comparison with established indices.
Clinicians should interpret these findings cautiously, recognizing that the association does not imply causation and that the marker is not yet ready for routine clinical implementation.
How this fits prior evidence
This meta-analysis extends prior coverage on prognostic markers in cancer by introducing a composite inflammation-immunity-nutrition score. It complements earlier findings on nutritional status (e.g., wasting in pediatric cancer) and systemic inflammation, but it is distinct from prior topics like AI decision support or immunotherapy toxicity. The results confirm the prognostic value of inflammatory and nutritional biomarkers, but the predominantly retrospective design and Chinese-only population limit generalizability, addressing a gap in multiethnic validation.
Researchers analyzed data from 3,950 cancer patients in China to look at how specific markers affect survival. They used a combined score called IINS, which looks at inflammation, immune system health, and nutrition levels together. This score combines three specific measurements: C-reactive protein, lymphocyte count, and albumin.
The study found that patients with a high IINS score were significantly more likely to have shorter progression-free survival and poorer overall survival. Specifically, the data showed a strong link between these elevated markers and worse outcomes for the patients involved in the analysis.
Because this research was based on retrospective data from a specific population in China, the results may not apply to everyone. The findings are currently used as a potential tool for doctors to predict patient progress. However, more studies involving different groups of people are needed before this score can be widely used in standard medical practice.
What this means for you:
A high IINS score is linked to poorer survival outcomes in cancer patients, but more diverse research is needed.
Common questions
What does the IINS score measure?
The IINS score is a combined measurement that looks at three specific factors: high-sensitivity C-reactive protein, lymphocyte count, and albumin. It is used to provide a single score reflecting inflammation, immunity, and nutrition levels in patients with cancer.
What did the study find about patient survival?
The analysis of 3,950 participants showed that an elevated IINS score was significantly associated with poorer overall survival and shorter progression-free survival. The data indicated a strong link between higher scores and worse outcomes for those patients.
Can this score be used to treat cancer?
The study does not show that the IINS score is a treatment. It is currently viewed as a potential prognostic marker, which helps doctors predict how a disease might progress. More multi-center and multi-ethnic studies are needed before it can be widely used.
BACKGROUND: Cancer remains a leading cause of mortality worldwide, with inflammation and immune dysregulation playing crucial roles in tumor progression. The inflammation-immunity-nutrition score (IINS), integrating high-sensitivity C-reactive protein, lymphocyte count, and albumin, has emerged as a potential prognostic biomarker in cancer, but its generalizability across tumor types is unclear.
METHODS: PubMed, Cochrane Library, and EMBASE were searched for studies up to September 2025 assessing the relationship between IINS and survival outcomes in cancer patients. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled using appropriate statistical models.
RESULTS: Eight eligible articles involving 3,950 unique participants contributed 11 non-overlapping analytic cohorts. All participants were from Chinese populations, and the evidence was predominantly retrospective, with one prospectively assembled validation cohort. Elevated IINS was significantly associated with poorer OS (HR = 2.13, 95% CI: 1.56-2.90, < 0.001) and shorter PFS (HR = 1.95, 95% CI: 1.65-2.31, < 0.001). The binary high-versus-low analyses and the graded IINS-category analyses were based on different sets of cohorts according to the form in which effect estimates were reported. Higher IINS categories were associated with progressively less favorable survival outcomes.
CONCLUSIONS: Elevated IINS is associated with poorer survival outcomes and may serve as an accessible prognostic marker in cancer. However, the current evidence is predominantly retrospective and entirely derived from Chinese populations. Prospective, multicentre, multiethnic validation and direct comparison with established prognostic indices are required before clinical implementation.
