Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Clin Anat. 2012 Jan;25(1):54-71. doi: 10.1002/ca.21249. Epub 2011 Aug 18.
There have been significant changes in the evaluation and management of lymphatic metastases in the neck during the past several decades, and knowledge of the functional anatomy of the cervical lymphatics is fundamental to the clinical management of metastasis in this region. This review provides a comprehensive description of the cervical lymphatics and discusses how this knowledge is used in the modern management of the neck lymphatics in the setting of common cancers of the head and neck. The patterns of tumor spread can be delineated based on the well-studied functional anatomy of the lymphatic networks in the cervical region. The characteristics and patterns of metastatic spread for two common cancers found in this region, squamous cell carcinoma and cutaneous malignant melanoma, are discussed in this review. Significant improvements in clinical care, namely, selective neck dissection and sentinel lymph node biopsy aided by lymphoscintigraphy, have been developed and are based upon detailed studies of the pathways of metastatic spread. These advances have significantly decreased the morbidity associated with the evaluation and treatment of metastatic disease to the neck.
在过去几十年中，颈部淋巴结转移的评估和管理发生了重大变化，对颈部淋巴系统的功能解剖的了解是对该区域转移进行临床管理的基础。本文全面描述了颈部淋巴管，并讨论了如何在头颈部常见癌症的背景下，将这方面的知识应用于现代颈部淋巴结的管理。可以根据颈部淋巴网络的已有充分研究的功能解剖来描绘肿瘤扩散的模式。本文讨论了在该区域发现的两种常见癌症（鳞状细胞癌和皮肤恶性黑色素瘤）的转移扩散特征和模式。临床护理的显著改善，即选择性颈部解剖和淋巴闪烁显像辅助下的前哨淋巴结活检，都是基于对转移扩散途径的详细研究而发展起来的，这些进展显著降低了评估和治疗颈部转移性疾病相关的发病率。
