原发性甲状旁腺功能亢进症（PHPT）在年龄超过55岁的美国人中影响2％，而在年轻患者中较不常见。小儿期PHPT患者具有更高的多发性腺体疾病（MGD）发病率。我们研究了年轻成年患者，以确定是否有类似提高的MGD发病率，并是否有必要进行常规双侧颈部探查手术。对2000年至2019年接受甲状旁腺切除术的PHPT患者进行了回顾性病历分析。患者按年龄分成两组：A组（18-40岁）和B组（>40岁）。进行了单变量和多变量逻辑回归分析。在3889名PHPT患者中，9.1％（n = 352）包括在A组中。在多元分析中，多发性内分泌肿瘤（OR 6.3，95％置信区间[CI] 3.1-12.7），男性（OR 1.3，95％ CI 1.0-1.5），PHPT家族史（OR 2.7，95％ CI 1.6-4.8），先前的甲状旁腺切除术（OR 2.2，95％ CI 1.6-3.0），以及非定位成像（OR 1.8，95％ CI 1.5- 2.1）与MGD相关联；年轻年龄不是独立的风险因素。在散发性PHPT患者中（n = 3833），家族史与MGD最强关联（OR 4.0，95％ CI 2.2-7.3）。在我们的散发性PHPT患者人群中，PHPT的阳性家族史与MGD密切相关，还发现了与先前的甲状旁腺切除术、非定位成像和男性有关的内在因素。年龄单独在没有家族史的情况下不应引起对MGD的怀疑，也不应确定需要双侧颈部探查手术。©2023年。外科肿瘤学会。

Primary hyperparathyroidism (PHPT) affects 2% of Americans over 55 years of age, and is less common in younger patients. Pediatric PHPT patients have higher rates of multigland disease (MGD). We studied young adult patients to determine whether they have similarly elevated rates of MGD and would benefit from routine bilateral neck exploration.Retrospective chart review was performed on patients who underwent parathyroidectomy for PHPT (2000-2019). Cohorts were defined by age: Group A (18-40 years) and Group B (> 40 years). Univariate and multivariate logistic regression analyses were performed.Of 3889 patients with PHPT, 9.1% (n = 352) were included in Group A. On multivariate analysis, multiple endocrine neoplasia (odds ratio [OR] 6.3, 95% confidence interval [CI] 3.1-12.7), male sex (OR 1.3, 95% CI 1.0-1.5), family history of PHPT (OR 2.7, 95% CI 1.6-4.8), prior parathyroidectomy (OR 2.2, 95% CI 1.6-3.0), and non-localizing imaging (OR 1.8, 95% CI 1.5-2.1) were associated with MGD; younger age was not an independent risk factor. In patients with sporadic PHPT (n = 3833), family history was most strongly associated with MGD (OR 4.0, 95% CI 2.2-7.3).In our population of patients with sporadic PHPT, a positive family history of PHPT was strongly associated with MGD; additional associations were found with prior parathyroidectomy, non-localizing imaging, and male sex. Younger age was not an independent risk factor. Age alone in the absence of a family history should not raise suspicion for MGD nor determine the need for bilateral neck exploration.© 2023. Society of Surgical Oncology.