甲状腺乳头状癌前上纵隔颈淋巴结清扫的治疗现状[综述]

甲状腺乳头状癌约占分化型甲状腺癌的90%以上。甲状腺乳头状癌容易较早出现区域性淋巴结转移。根据最新的美国癌症综合委员会（AJCC）第8版甲状腺癌分期系统，前上纵隔淋巴结（Ⅶ区）淋巴结转移也已从第7版的N1b更改为N1a（VI区或VII区淋巴结转移，单侧或双侧），而甲状腺乳头状癌前上纵隔颈淋巴结是否归属于中央区淋巴结进行清扫一直存在着争议。本文将从颈淋巴结的解剖分区及术式选择、中央区淋巴结的定界（前上纵隔淋巴结是否归属于中央区淋巴结）以及前上纵隔淋巴结的清扫相关研究，对甲状腺乳头状癌前上纵隔颈淋巴结清扫的治疗现状做一综述，以便进一步指导临床工作。

Current situation of the treatment about anterior and superior mediastinal lymph node dissection of thyroid papillary carcinoma

Thyroid papillary carcinoma accounts for over 90% of the differentiated thyroid carcinoma.Regional lymph node metastasis of the thyroid carcinoma occurs earlier.According to the 8th edition American Joint Committee on Cancer(AJCC)Staging System,anterior and superior mediastinal lymph nodes metastasis(Level Ⅶ)has also been changed from N1b to N1a(Level Ⅵ or Ⅶ lymph node metastasis,unilateral or bilateral).However,whether anterior and superior mediastinal lymph nodes belongs to the central lymph node has been controversial.To guide further clinical work,this paper will make a reviews about the current situation of treatment of node dissection for thyroid papillary carcinoma from these aspects,anatomical division and surgical method of neck lymph node,demarcation of central lymph nodes(whether the anterior and superior mediastinal lymph nodes belong to central lymph nodes)and current study of anterior and superior mediastinal lymph nodes dissection.