Predictive value of serum heat shock protein 90α combined with annexin A3 and tumor-infiltrating lymphocytes for neoadjuvant chemotherapy efficacy in breast cancer patients

Bai Wenhui; Li Ying; Ma Dengyun; Zhang Jin; Pang Wenjing

doi:10.3760/j.issn.1673-4777.2026.04.009

Abstract：Objective To explore the predictive value of serum heat shock protein 90α(HSP90α),annexin A3(ANXA3)combined with tumor-infiltrating lymphocytes(TILs)for the efficacy of neoadjuvant chemo-therapy(NAC)in breast cancer patients.Methods A total of 234 breast cancer patients(all receiving NAC)admitted to Qinghai Red Cross Hospital from April 2022 to February 2025 were prospectively enrolled.They were divided into an effective group and an ineffective group according to the efficacy of NAC.The serum levels of HSP90α and ANXA3 were detected by enzyme-linked immunosorbent assay,and the proportion of TILs was evaluated after hematoxylin-eosin staining.Logistic regression was used to analyze the influencing factors of NAC efficacy in breast cancer.Receiver operating characteristic curve was used to analyze the predictive value of serum HSP90α,ANXA3 combined with TILs for NAC efficacy in breast cancer.Results The serum levels of HSP90α and ANXA3 in the ineffective group were significantly higher than those in the effective group[(4.5±1.0)μg/L vs(2.9±1.0)μg/L,(6.0±1.1)μg/L vs(4.4±1.0)μg/L],while the TILs proportion was significantly lower than that in the effective group[(16.2±2.2)％vs(52.4±3.4)％](all P＜0.05).The areas under the curve(AUC)of serum HSP90α,ANXA3 and TILs for predicting NAC efficacy in breast cancer were 0.751,0.825 and 0.815,respectively,and the AUC of the combination of the three was 0.920,which was significantly higher than that of each single index(Z=2.701,2.742,2.757,all P＜0.05).HSP90α,ANXA3 and TILs were all correlated with molecular subtype,lymph node status and human epidermal growth factor receptor 2(HER-2)status of breast cancer patients(all P＜0.05).Logistic regression analysis showed that lymph node status,HER-2 status,HSP90α and ANXA3 were risk factors for NAC efficacy in breast cancer,while TILs was a protective factor(all P＜0.05).Conclusion The serum levels of HSP90α,ANXA3 and TILs in breast cancer patients show abnormal changes.Lymph node status,HER-2 status,HSP90α,ANXA3 and TILs are influencing factors of NAC efficacy in breast cancer,and the combination of HSP90α,ANXA3 and TILs has a certain predictive value for NAC efficacy in breast cancer patients.