Lacau St Guily Jean Lacau
Service d'ORL et chirurgie cervico-faciale, hôpital Tenon & UFR Pierre et Marie-Curie, Université Paris 6, 75970 Paris.
Rev Prat. 2006 Oct 15;56(15):1652-7.
Prognosis of head and neck squamous cell carcinomas (HNSCC) is partly determined by lymph nodes metastases. Contemporary imaging provides detection of adenopathies but remains unable to detect infracentimetric micrometastatic nodes. Topographical classification according to Robbins allows for better treatment through proper definition of impaired neck areas. The high rate of node metastases in HNSCC indicates systematic treatment of the neck in most localizations. Several neck dissection techniques are available with wide acceptation of elective functional neck dissections. Improvement of detection of node metastases and better selection of neck sites for treatment are eventual direction of progress. In neck carcinoma with unknown primary, search of primary should address first head and neck area and upper aero-digestive tract. Differential diagnosis are glomic tumour, congenital cyst and other causes of lymph node disease
头颈部鳞状细胞癌（HNSCC）的预后部分取决于淋巴结转移情况。当代影像学检查能够发现淋巴结肿大，但仍无法检测出小于一厘米的微转移淋巴结。根据罗宾斯分类法进行的地形学分类，通过正确定义颈部受累区域，有助于更好地进行治疗。HNSCC中淋巴结转移的高发生率表明，在大多数情况下都需要对颈部进行系统性治疗。目前有多种颈部清扫技术可供选择，选择性功能性颈部清扫术已被广泛接受。提高淋巴结转移的检测率以及更好地选择颈部治疗部位是未来的发展方向。对于原发灶不明的颈部癌，首先应排查头颈部区域和上呼吸道消化道。鉴别诊断包括副神经节瘤、先天性囊肿以及其他导致淋巴结病变的原因
