摘要 ：目的 寻找那些可以预测非前哨淋巴结转移的因素。方法 本研究回顾性分析了1999.5～2015.9在我院进行乳腺癌前哨淋巴结活检的病例，通过多因素分析判断哪些临床病理因素与非前哨淋巴结转移相关。 结果 总共有162例患者进行了前哨淋巴结活检和腋窝清扫，多因素分析表明原发肿瘤直径>2cm（P=0.023），前哨淋巴结转移灶直径>2mm（P=0.016）和脉管浸润（P=0.001）是非前哨淋巴结转移的独立预测因素，患者的具有的不良因素越多，则非前哨淋巴结发生转移的可能性越大。结论 非前哨淋巴结是否转移与原发肿瘤大小、前哨淋巴结转移灶最大径和脉管浸润有关，对原发肿瘤及其前哨淋巴结进行详细的病理学检查将有助于筛查出真正需要进行腋窝清扫的患者。

Abstract Background: To investigate factors that predict involvement of non-sentinel lymph nodes(nSLNs) in patients with positive SLNs. Methods: We reviewed the records of all patients with invasive breast cancer who underwent SLN biopsy at our institution between May 1999 and September 2015. Multivariate analysis was used to identify clinicopathologic features in SLN-positive patients that predict involvement of nSLNs. Results: A total of 108 patients had a positive SLN and underwent completion axillary lymph node dissection. Multivariate analysis revealed that primary tumor >2cm(P=0.024), SLN metastasis >2mm(P=0.015), and lymphovascular invasion (P=0.001) were independent predictors of positive nSLNs. The more above variable the patient has, the higher the likelihood of positive nSLN is. Conclusions: The likelihood of positive nSLNs correlates with primary tumor size, size of the largest SLN metastasis, and presence of lymphovascular invasion. Detailed pathologic examination of the primary tumor and its SLN metastases may increase precision in the selection of patients for further axillary surgery.