淋巴结是食管癌转移的主要部位,其淋巴引流区域涉及颈部、胸部和腹部,对其检测和监测有着重要的临床意义。目前科技不断发展,各种检查手段不断应用于临床,有利于对病情进行客观准确的评价。另外,食管癌的淋巴结转移受肿瘤分化程度、浸润深度、肿瘤长度等多种因素的共同影响,其中部分因素还存在一些不同的观点或认识。因此,准确的术前淋巴结(N)分期和术中评估为临床淋巴结清扫范围提供了重要指导。由于病理诊断技术的进步,对淋巴结微转移的认识和检测使N分期的准确率得到进一步提高。多数研究认为食管癌有淋巴结转移明显影响着预后,然而新的国际TNM分期中仅将淋巴结转移状况分为N1和N0两种状态,而未将淋巴结转移部位、数量及频度等考虑在内。根治性手术仍是治疗食管癌主要手段之一,食管切除及淋巴结清扫术的开展明显提高了食管癌病人生存率,但对于食管癌淋巴结清扫范围的界定目前尚缺乏统一的认识,且术后并发症也随手术范围的扩大而增加。随着研究的不断深入,各种报道不断地对食管癌现有N分期进行再认识和补充,多角度地阐明淋巴结转移所产生的不良影响,这将有助于我们更加全面和深入地认识和理解N分期,进而指导临床选择个体化的手术方式。 Lymph nodes are the main part of esophageal cancer metastasis. The lymphatic drainage area involves the neck, chest and abdomen. It has important clinical significance for its detection and monitoring. The continuous development of science and technology, various means of inspection continue to be used in clinical, is conducive to the objective and accurate evaluation of the disease. In addition, the lymph node metastasis of esophageal cancer by the degree of tumor differentiation, depth of invasion, tumor length and other factors together, some of which there are still some different views or understanding. Therefore, accurate preoperative lymph node (N) staging and intraoperative assessment of the clinical lymph node dissection provides an important guide. As the pathological diagnosis of technology advances, awareness and detection of lymph node micrometastasis so that the accuracy of N staging has been further improved. Most studies suggest that lymph node metastasis of esophageal cancer significantly affect the prognosis, however, the new international TNM staging only the status of lymph node metastasis into N1 and N0 two states, but did not take into account the location of the lymph node metastasis, number and frequency. Radical surgery is still one of the main ways to treat esophageal cancer. Esophagectomy and lymphadenectomy significantly improve the survival rate of patients with esophageal cancer, but the definition of lymph node dissection of esophageal cancer is still lack of a unified understanding, and postoperative complications Disease also increased with the expansion of the scope of surgery. With the deepening of the research, various reports continue to re-recognize and supplement the existing N staging of esophageal cancer, multi-angle clarify the adverse effects of lymph node metastasis, which will help us to more comprehensive and in-depth understanding and Understand the N staging, and then guide the individual clinical choice of surgical approach.