张帅,蒋孝会

• 1:湖北省肿瘤医院头颈外科
• 2:湖北省肿瘤医院妇瘤科

摘要(Abstract)：

目的:探讨非妊娠低龄甲状腺乳头状癌(papillary thyroid carcinoma, PTC)患者不同年龄段临床特征，为精准化的临床治疗提供依据。方法:回顾性分析2020年1月至2026年1月于湖北省肿瘤医院头颈外科收治的186例年龄18～35岁、非妊娠PTC患者的临床资料，所有患者均经术后常规病理检查确诊为经典型PTC。按年龄分为18～25岁组(106例)和26～35岁组(80例),比较2组临床病理特征，并分析PTC伴淋巴结转移的相关因素。比较2组患者的肿瘤最大直径、多灶性、甲状腺被膜侵犯、甲状腺外侵犯、合并桥本甲状腺炎、术前血清促甲状腺激素(TSH)、术前血清甲状腺球蛋白(Tg)及体重指数(BMI),并分析上述临床特征与该类患者中央区淋巴结转移(CLNM)的关系。结果:18～25岁组肿瘤最大直径>1 cm者比例、被膜侵犯率、CLNM发生率、CLNM转移淋巴结数目>2枚者比例及BMI水平均高于26～35岁组(分别P<0.01、P<0.01、P<0.05、P<0.01、P<0.05);而2组在多灶性、腺外侵犯、侧颈淋巴结转移、术前TSH及术前Tg方面差异均无统计学意义(P>0.05)。在CLNM的相关因素分析中，肿瘤最大直径>1 cm、腺外侵犯、侧颈淋巴结转移及术前TSH、术前Tg水平升高均与CLNM发生相关(分别P<0.01、P<0.01、P<0.05、P<0.05、P<0.01),而多灶性、被膜侵犯、合并桥本甲状腺炎及BMI水平与CLNM转移差异均无统计学意义(P>0.05)。结论:在非妊娠低龄PTC患者中，年龄更低者肿瘤直径可能更大，更易发生甲状腺被膜侵犯，BMI相对较高，但合并桥本甲状腺炎的比例较低；术前血清Tg水平升高可能是中央区淋巴结转移的重要危险因素。本研究可为非妊娠低龄PTC患者术前治疗方案制定及术后个体化随访提供一定的临床依据。

关键词(KeyWords)： 甲状腺乳头状癌;非妊娠低龄;中央区淋巴结转移;临床特征

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张帅,蒋孝会

DOI: 10.13201/j.issn.2096-7993.2026.10.005

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