EVALUATING PROGNOSIS IN ATHLETES UNDERGOING TARGETED THERAPY FOR ADVANCED LUNG ADENOCARCINOMA: THE ROLE OF NLR, PLR, AND PNI

Abstract

Objective: This study aims to explore the prognostic significance of Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in peripheral blood, and the Prognostic Nutritional Index (PNI) in athletes diagnosed with advanced lung adenocarcinoma undergoing targeted therapy. Methods: A retrospective analysis was conducted on 54 athletes with lung adenocarcinoma, confirmed pathologically and characterized by exon 19 or 21 mutations. Data on pre-treatment levels of NLR, PLR, and PNI were collected from medical records, with overall survival (OS) outcomes obtained via records and telephone follow-up. Statistical analysis involved Receiver Operating Characteristic (ROC) curves, Kaplan-Meier survival curves, log-rank tests, and Cox regression. Results: Among the studied variables—gender, age, clinical stage, EGFR mutation type, lymph node metastasis, treatment type, tyrosine kinase inhibitor (TKI) use, carcinoembryonic antigen (CEA) levels, and cancer antigen 125 (CA125) levels—none showed a significant correlation with OS. However, elevated NLR was notably associated with reduced survival times, which was statistically significant. Multivariate analysis identified high NLR as an independent predictor of shorter OS (P=0.042, 95%CI: 0.002-1.023). Conclusion: NLR stands out as a convenient and reliable biomarker for assessing the prognosis of athletes with advanced lung adenocarcinoma post-targeted therapy. Understanding these relationships can assist in tailoring follow-up and therapeutic strategies, potentially improving outcomes for athletic individuals who face unique challenges in balancing cancer treatment with the demands of continuing sports participation.