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Purpose <p>Lactate dehydrogenase A (LDHA) is a key node in tumor growth, metabolism, and invasion and is upregulated across multiple cancers. However, the molecular mechanisms by which LDHA influences breast cancer (BC) remain unclear. We analyzed public datasets and an institutional cohort to clarify the relationship between LDHA and BC, with the aim of informing future therapeutic strategies.</p> Patients and methods <p> Using The Cancer Genome Atlas (TCGA), we assessed LDHA expression in BC and examined its associations with tumor mutational burden (TMB), immune cell infiltration, immune checkpoint molecules, and drug sensitivity. We integrated multiple databases and used Kaplan–Meier analyses to evaluate prognostic value. To explore biological functions of LDHA, we performed Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA). We then analyzed BC patients receiving neoadjuvant chemotherapy (NAC) at Harbin Medical University Cancer Hospital to test the relationship between serum lactate dehydrogenase (LDH) and pathological complete response (pCR). Finally, we used National Health and Nutrition Examination Survey (NHANES) data to examine the association between serum LDH and mortality.</p> Results <p> LDHA was upregulated in BC tissues, and higher expression was significantly associated with worse overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS). Functional analyses indicated enrichment of metabolic pathways, such as glycolysis. LDHA expression correlated with multiple immune cell populations, suggesting involvement in the tumor immune microenvironment. Lower LDHA expression was associated with greater sensitivity to several chemotherapeutic agents. In our institutional cohort, patients with lower serum LDH were more likely to achieve pCR, and LDH was an independent predictor of pCR. In NHANES, elevated serum LDH was linked to increased mortality risk.</p> Conclusion <p> Our findings suggest that LDHA expression and serum LDH levels are promising prognostic biomarkers for survival and may predict chemotherapy response in BC patients. These results highlight the clinical relevance of LDHA-mediated metabolic pathways. However, as a correlational study, our findings warrant further validation through functional experiments to confirm LDHA's role as a potential therapeutic target.</p>

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Lactate dehydrogenase a is a crucial biomarker that affects the prognosis, chemotherapy effect, and immune infiltration of breast cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月17日

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  • Jing Qi Xia,
  • Yi Lin Wang,
  • Xue Lian Li,
  • Jia Nan Wang,
  • Fu Cheng Li,
  • Si Yuan Jia,
  • Yu Ling Ba,
  • Dan Li Luo,
  • Tian Gao,
  • Zhao Ting Li,
  • Min Xiao,
  • He Dou

摘要

Purpose

Lactate dehydrogenase A (LDHA) is a key node in tumor growth, metabolism, and invasion and is upregulated across multiple cancers. However, the molecular mechanisms by which LDHA influences breast cancer (BC) remain unclear. We analyzed public datasets and an institutional cohort to clarify the relationship between LDHA and BC, with the aim of informing future therapeutic strategies.

Patients and methods

Using The Cancer Genome Atlas (TCGA), we assessed LDHA expression in BC and examined its associations with tumor mutational burden (TMB), immune cell infiltration, immune checkpoint molecules, and drug sensitivity. We integrated multiple databases and used Kaplan–Meier analyses to evaluate prognostic value. To explore biological functions of LDHA, we performed Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA). We then analyzed BC patients receiving neoadjuvant chemotherapy (NAC) at Harbin Medical University Cancer Hospital to test the relationship between serum lactate dehydrogenase (LDH) and pathological complete response (pCR). Finally, we used National Health and Nutrition Examination Survey (NHANES) data to examine the association between serum LDH and mortality.

Results

LDHA was upregulated in BC tissues, and higher expression was significantly associated with worse overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS). Functional analyses indicated enrichment of metabolic pathways, such as glycolysis. LDHA expression correlated with multiple immune cell populations, suggesting involvement in the tumor immune microenvironment. Lower LDHA expression was associated with greater sensitivity to several chemotherapeutic agents. In our institutional cohort, patients with lower serum LDH were more likely to achieve pCR, and LDH was an independent predictor of pCR. In NHANES, elevated serum LDH was linked to increased mortality risk.

Conclusion

Our findings suggest that LDHA expression and serum LDH levels are promising prognostic biomarkers for survival and may predict chemotherapy response in BC patients. These results highlight the clinical relevance of LDHA-mediated metabolic pathways. However, as a correlational study, our findings warrant further validation through functional experiments to confirm LDHA's role as a potential therapeutic target.