子宫颈癌在女性恶性生殖系统肿瘤中的发生率居于首位,其中腹主动脉旁淋巴结(para-aortic lymph node PALN)转移与宫颈癌的治疗、预后密切相关。宫颈癌的淋巴转移途经多为宫颈旁、宫旁转移到闭孔、髂内外,再转移到髂总、骶前,最终汇集于腹主动脉旁淋巴结及(或)转移至锁骨上或腹股沟深淋巴结的阶梯式转移,但也存在不经过盆腔淋巴结的跳跃式转移。肿瘤的临床分期、有无宫旁浸润、盆腔淋巴结转移情况以及治疗前SCC值等被认为是影响腹主动脉旁淋巴结转移的重要因素。术前评价淋巴结是否转移大多通过影像学诊断,CT通过显示淋巴结在横断面上的最大直径以及淋巴结内部密度改变来评价淋巴结是否转移,是目前应用最广泛的诊断方法,但其敏感性及准确性均低于PET。肿大的腹主动脉旁淋巴结可以手术切除,特别是腹膜外腹主动脉旁淋巴结切除术以及腹腔镜下腹主动脉旁淋巴结切除术,由于其创伤小、对术后放疗影响小等优点逐渐发展起来,既能诊断,同时也有重要的治疗价值。腹主动脉旁淋巴结是宫颈癌治疗后最常见的复发部位之一,但被认为更多是局部病变,对复发淋巴结区域采取积极治疗仍可明显改善生存率。但初治时即存在腹主动脉旁淋巴结转移者,患者往往同时有远处转移或会在较短时间内出现远处转移,预后差。 The incidence of cervical cancer in female malignant reproductive system tumors in the first place, of which a para-aortic lymph node metastasis and cervical cancer is closely related to the prognosis. Cervical lymph node metastasis mostly by the cervix next to the uterus to the obturator and iliac inside and outside, and then transferred to the common iliac, presacral, eventually converging in the para-aortic lymph nodes and / or metastasis to the supraclavicular or inguinal deep lymph nodes Of the ladder transfer, but there are also skip the pelvic lymph node metastasis. The clinical stage of the tumor, presence or absence of uterine infiltration, pelvic lymph node metastasis and SCC before treatment are considered as important factors affecting the para-aortic lymph node metastasis. Preoperative evaluation of lymph nodes metastasis mostly by imaging diagnosis, CT by the maximum diameter of the cross-section of the lymph nodes and lymph node density changes to assess the lymph node metastasis, is currently the most widely used diagnostic method, but its sensitivity and accuracy All lower than PET. Enlarged abdominal aortic lymph nodes can be surgically removed, especially extraperitoneal abdominal aortic lymph node dissection and laparoscopic abdominal aortic lymph node resection, because of its less traumatic impact on postoperative radiotherapy gradually developed , Can diagnose, but also has important therapeutic value. Paralysis of the para-aortic lymph nodes is one of the most common sites of recurrence after cervical cancer treatment, but is considered more localized disease, active treatment of recurrent lymph node area can still significantly improve the survival rate. However, when the first treatment of abdominal aorta lymph node metastasis, patients often have distant metastasis or distant metastasis in a relatively short period of time, the prognosis is poor.