2026 年第 4 期 第 21 卷

血清热休克蛋白90α与膜联蛋白A3联合肿瘤浸润淋巴细胞对乳腺癌患者新辅助化疗效果的预测价值

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

作者：白文辉李英马登云张瑾庞文静

英文作者：Bai Wenhui Li Ying Ma Dengyun Zhang Jin Pang Wenjing

单位：青海红十字医院乳腺外科，西宁810000

英文单位：Department of Breast Surgery Qinghai Red Cross Hospital Xining 810000 China

关键词：乳腺癌；新辅助化疗；热休克蛋白90α；膜联蛋白A3；肿瘤浸润淋巴细胞

英文关键词：Breastcancer;Neoadjuvantchemotherapy;Heatshockprotein90α;AnnexinA3;Tumor-infiltratinglymphocytes

• 摘要：

• 目的 探讨血清热休克蛋白90α（HSP90α）、膜联蛋白A3（ANXA3）联合肿瘤浸润淋巴细胞（TILs）对乳腺癌患者新辅助化疗（NAC）效果的预测价值。方法 前瞻性选取青海红十字医院2022年4月至2025年2月收治的234例乳腺癌患者（均行NAC），根据NAC效果分为有效组和无效组，酶联免疫吸附试验法检测血清HSP90α、ANXA3水平，经苏木精-伊红染色后评估TILs比例，采用Logistic回归方法 分析乳腺癌NAC效果的影响因素；受试者工作特征曲线分析血清HSP90α、ANXA3联合TILs对乳腺癌NAC效果的预测价值。结果 无效组血清HSP90α、ANXA3水平均高于有效组［（4.5±1.0）μg/L比（2.9±1.0）μg/L、（6.0±1.1）μg/L比（4.4±1.0）μg/L］，TILs比例低于有效组［（16.2±2.2）%比（52.4±3.4）%］（均P＜0.05）。血清HSP90α、ANXA3及TILs预测乳腺癌NAC效果的曲线下面积（AUC）为0.751、0.825、0.815，三者联合预测乳腺癌NAC效果的AUC为0.920，联合预测的AUC高于各自单独预测（Z=2.701、2.742、2.757，均P＜0.05）。HSP90α、ANXA3、TILs均与分子分型、乳腺癌患者淋巴结状态和人表皮生长因子受体2（HER-2）状态有关（均P＜0.05）。Logistic回归分析结果显示，淋巴结状态、HER-2状态、HSP90α、ANXA3为乳腺癌NAC效果的危险因素，TILs为保护因素（均P＜0.05）。结论 乳腺癌患者血清HSP90α、ANXA3水平及TILs均异常变化，淋巴结状态、HER-2状态、HSP90α、ANXA3、TILs为乳腺癌NAC效果的影响因素，HSP90α、ANXA3、TILs三者联合对乳腺癌患者NAC效果有一定的预测价值。

• 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 chemotherapy (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.