甲状腺异常是儿童癌症幸存者中常见的迟发效应。我们基于诊断和治疗方法分析了甲状腺异常的患病率和危险因素。将回顾性地纳入了257名在20岁以下被诊断为癌症的幸存者。他们的中位年龄是11.8岁（0.1-19.8）。在治疗完成后的中位随访期为9.6年（5.0-19.5）。在257名幸存者中，有107人（41.6%）出现甲状腺异常。其中65人（25.3%）患有亚临床甲状腺功能减退症，16人（6.2%）患有中枢性甲状腺功能减退症，5人（1.9%）患有原发性明显甲状腺功能减退症，5人（1.9%）患有自身免疫性甲状腺炎，6人（2.3%）患有甲状腺癌。在不同的诊断组中，脑肿瘤或霍奇金病或鼻咽癌组的甲状腺异常较为频繁。与其它幸存者相比，直接或接近下丘脑-垂体-甲状腺轴向的照射幸存者患甲状腺异常的数量更多（P<0.0001）。接受造血干细胞移植幸存者甲状腺异常的患病率（60.5%）高于其它幸存者（37.9%）（P=0.0069）。在107名患有甲状腺异常的幸存者中，有45人（42%）的甲状腺激素水平已在最后一次随访时恢复正常。直接或接近下丘脑-垂体-甲状腺轴的照射被认为是持久性亚临床甲状腺功能减退症的预测因素。亚临床甲状腺功能减退症在幸存者中很常见，而直接或接近下丘脑-垂体-甲状腺轴的照射则容易导致甲状腺功能障碍持续。©2023. 作者（们）。

Thyroid abnormality is a common late effect seen in childhood cancer survivors (CCSs). We analyzed the prevalence and risk factors of thyroid abnormalities based on diagnoses and treatment modalities in CCSs.The medical records of 257 CCSs who were diagnosed with cancer less than 20 year of age were retrospectively reviewed. The median age was 11.8 years (0.1-19.8). The median follow-up period after completion of therapy was 9.6 years (5.0-19.5).Of 257 subjects, thyroid abnormalities were identified in 107 (41.6%). Sixty-five out of 257 (25.3%) had subclinical hypothyroidism, and 16 (6.2%) developed central hypothyroidism. Five CCSs (1.9%) had primary overt hypothyroidism. Five (1.9%) and 6 (2.3%) CCSs were diagnosed with autoimmune thyroiditis and thyroid cancer, respectively. Among the different diagnostic groups, thyroid abnormalities were frequent in the brain tumor or Hodgkin disease or nasopharyngeal cancer groups. CCSs who received irradiation directly or near hypothalamus-pituitary-thyroid (HPT) axis had more thyroid abnormalities compared to the rest CCSs (P < 0.0001). CCSs who were treated with SCT had an increased prevalence of thyroid abnormalities (60.5%) compared to the other CCSs (37.9%) (P = 0.0069). Forty-five (42%) of 107 subjects with thyroid abnormalities had normalized thyroid hormone levels at the last follow-up. Irradiation directly or near HPT axis were thought to be a predicting factor of persistent subclinical hypothyroidism.Subclinical hypothyroidism was common in CCSs. CCSs with irradiation directly or near HPT axis were at risk for persistent thyroid dysfunction.© 2023. The Author(s).