ObjectiveTo assess the clinical value of liquid biopsy in breast cancer care, with a focus on its potential to complement tissue biopsy in diagnosis, treatment monitoring, and disease management. MethodA narrative review of recent literature was performed, examining the biological basis and clinical relevance of key liquid biopsy markers, including circulating tumor DNA (ctDNA), circulating tumor cells, and extracellular vesicles, in the context of breast cancer. ResultsAmong the markers reviewed, ctDNA can non-invasively detect mutations in key genes, such as ESR1, PIK3CA, HER2, and BRCA1/2, with results that are largely consistent with those from tissue samples. In addition to mutation testing, ctDNA can be measured repeatedly over time, making it useful for early screening, monitoring of high-risk individuals, efficacy evaluation, evolution of drug-resistant clones, and monitoring of minimal residual disease. Circulating tumor cells count and phenotypic analysis provide prognostic information regarding recurrence risk and survival, and single cell analysis helps reveal tumor spatiotemporal heterogeneity. Extracellular vesicles carry nucleic acids and proteins of tumor origin and have shown potential value in early diagnosis and disease monitoring. Liquid biopsy has shown clinical value in the diagnosis of advanced breast cancer, including cases with central nervous system involvement. However, current limitations in detection sensitivity and specificity, combined with the lack of standardized testing procedures, continue to restrict its clinical use. As a result, tissue biopsy remains the gold standard for initial pathological diagnosis and molecular classification. ConclusionsLiquid biopsy and tissue biopsy have different but complementary roles in breast cancer care. Tissue biopsy remains the basis for diagnosis and molecular subtyping, while liquid biopsy is more suitable for continuous monitoring and molecular stratified guidance over the course of disease. With advances in detection methods, combined use of multiple markers, improved standardization, and the integration of artificial intelligence for multi-omics data analysis, liquid biopsy holds promise for advancing more personalized and dynamic management for breast cancer patients.
Objective To evaluate the effectiveness of early internal fixation combined with free anterolateral thigh perforator flap (ALTPF) transplantation in the treatment of open ankle fracture-dislocation. Methods A retrospective analysis was performed on the clinical data of 13 patients with open ankle fracture-dislocation who were admitted and met the inclusion criteria between January 2021 and May 2024. Among them, there were 9 males and 4 females, with the ages ranging from 23 to 61 years (mean, 45.3 years). Fracture types included 5 cases of simple medial or lateral malleolar fracture-dislocation, 7 cases of bimalleolar (medial and lateral) fracture-dislocation, and 1 case of trimalleolar fracture-dislocation. Additionally, 3 cases were complicated with bone defects (1 medial malleolus defect and 2 lateral malleolus defects). All injuries were classified as type ⅢB according to the Gustilo-Anderson classification for open fractures. The size of wound defects ranged from 7 cm×5 cm to 18 cm×12 cm. The time from injury to surgery was 2-20 hours (mean, 4 hours). All patients underwent emergency thorough debridement upon admission. The fracture-dislocation was temporarily stabilized with an external fixator, and the wound was covered with antibiotic-impregnated bone cement sheets or vacuum sealing drainage. Definitive internal fixation of the fracture and free ALTPF transplantation were performed 5-7 days after the initial emergency procedure. Postoperatively, wound healing, flap survival, and fracture union were monitored. At last follow-up, clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results All 13 patients were followed up 6-24 months (mean, 8.2 months). All flaps survived completely, and all fractures achieved union, with an union time of 3-11 months (mean, 5.5 months). One patient developed a superficial infection at the wound margin, which healed after regular dressing changes and drainage. No internal fixation-related complication (e.g., deep infection, implant loosening, or secondary ankle instability) were observed. At last follow-up, the total AOFAS ankle-hindfoot score was 78.6±13.5, with 3 excellent, 7 good, 2 fair, and 1 poor cases, yielding an excellent and good rate of 76.9%. ConclusionEarly internal fixation combined with ALTPF transplantation for open ankle fracture-dislocation can shorten the treatment course and maximize the recovery of ankle joint function.
