Abstract: 【Abstract】 Objective To evaluate the correlation between non?sentinel lymph nodes（nSLN） metastasis and clinic?pathologic features in primary breast cancer patients with 1 or 2 sentinel lymph nodes（SLN） metastasis. Methods Retrospectively analyzed clinical and pathological data of 118 primary breast cancer patients with 1 or 2 positive sentinel lymph nodes and axillary lymph nodes dissection in The 2nd Affiliated Hospital of Guangzhou Medical University. Chi-square test and Logistic regression were used for univariate and multivariate analysis separately. Results 45.8%（54/118）of all patients with positive non?sentinel lymph nodes metastasis. Univariate analysis revealed nSLN metastasis was associated with tumor size, intravascular tumor thrombus and ratio of SLN metastasis（all P values less than 0.05）. Multivariate analysis showed that tumor size , intravascular tumor thrombus and ratio of SLN metastasis were independent influencing factors of nSLN metastasis（OR=3.159, 2.425, 2.258, all P values less than 0.05）. Conclusion In 1 or 2 positive SLN breast cancer patients with tumor size≥2 cm, intravascular tumor thrombus or ration of SLN metastasis≥2/3 are prone to have metastasis in nSLN.

Key words: metastasis, sentinel lymph nodes metastasis, non?sentinel lymph nodes, breast neoplasms

摘要： 【摘要】目的 分析1~2枚前哨淋巴结（SLN）阳性乳腺癌患者的临床病理因素与非前哨淋巴结（nSLN）转移的关系。方法 回顾性分析2012年1月至2015年12月期间广州医科大学附属第二医院乳腺外科1~2枚SLN阳性且同时行腋窝淋巴结清扫的118例早期浸润性乳腺癌患者临床病理资料，分别应用χ2检验及Logistic回归进行单因素及多因素分析。结果 nSLN未转移（nSLN-）组患者64例，nSLN转移（nSLN+）组患者54例。单因素分析显示nSLN转移与肿瘤大小、脉管癌栓、SLN转移比例有关（P=0.001，P=0.030，P=0.002），但与年龄、绝经状态、病理类型、肿瘤位置、核分级、SLN转移数目、ER、PR、C?erBb?2、Ki67无关（均P>0.05）。多因素分析显示肿瘤大小、脉管癌栓、SLN转移比例均为nSLN转移的独立影响因素（OR分别为3.159，2.425，2.258，均P<0.05）。结论 肿瘤大小≥2cm、脉管癌栓、SLN转移比例≥2/3均为1~2枚SLN阳性乳腺癌患者nSLN转移的独立不良影响因素。

关键词: 前哨淋巴结转移, 乳腺肿瘤, 非前哨淋巴结转移