食管鳞癌喉返神经旁淋巴结转移危险因素的研究进展

Research progress of risk factors of recurrent laryngeal nerve lymph node metastasis in esophageal squamous cell carcinoma

喉返神经旁淋巴结转移(recurrent laryngeal nerve lymph node metastasis,RLN LNM)是食管癌(esophageal cancer,EC)转移的主要方式之一,阳性患者术后总体生存较差,同时RLN LNM多提示颈部淋巴结转移风险,进而导致患者预后不良。此外,喉返神经旁淋巴结清扫也是EC根治术的重点和难点之一。近年来关于食管鳞癌RLN LNM的研究逐渐增多,研究者普遍认为肿瘤分化程度和浸润深度是影响RLN LNM的重要危险因素,但肿瘤位置、肿瘤最大径和区域淋巴结转移等因素与RLNLNM的具体关系仍存在争议。本文就国内外有关食管鳞癌RLN LNM的危险因素(原发肿瘤、淋巴结等)、模型建立及在颈部淋巴结转移中的价值做一综述,为评估食管鳞癌RLN LNM风险,制定最佳治疗策略,进一步改善患者预后提供参考依据。

Recurrent laryngeal nerve lymph node metastasis(RLN LNM) is one of the main ways of esophageal cancer metastasis.Positive patients have worse overall survival after surgery.At the same time,RLN LNM often indicates the risk of cervical lymph node metastasis,which leads to poor prognosis.In addition,the resection of the recurrent laryngeal lymph nodes is also one of the key points and difficulties in esophagectomy.In recent years,research on the risk factors of RLN LNM in esophageal squamous cell carcinoma has gradually increased.Researchers generally believe that tumor differentiation and depth of invasion are important risk factors of RLN LNM,but there is a controversy about the relationship of tumor location,tumor maximum diameter and regional lymph node metastasis with RLN LNM.In order to assess the risk factors(primary tumors,lymph nodes,etc.),model construction,and predictive value for cervical LNM of RLN LNM in esophageal squamous cell carcinoma,and provide a reference basis for developing optimal treatment strategies and improving patient outcomes,this article reviews the progress of risk factors of RLN LNM in esophageal squamous cell carcinoma at home and abroad.