这项研究旨在确定价值和最佳年龄截止值，以预测活动监视期间高度可疑的甲状腺结节≤10毫米的进展，并揭示不同年龄患者的明显风险因素。总共779名高度可疑甲状腺结节患者接受超声随访。使用R的局部加权散点图平滑（LOWESS）和包“changepoint”来确定最佳年龄截止值。进行多元Cox回归，以识别根据年龄分组的每个患者组中的独立预后因子。年龄是结节进展的独立预测因子（P = 0.038）。将年龄截止值优化为30岁，以分层结节进展风险。年轻患者在活动监视期间更有可能出现结节进展（P <0.001），包括结节大小增大（P = 0.011）和新病变发生（P <0.001）。结节大小被确定为30岁以下患者疾病进展的风险因素（P = 0.008，OR 7.946，95％CI 1.715-36.820），而多灶性（P = 0.018，OR 2.315，95％CI 1.155-4.639）和甲状腺炎（P = 0.028，OR 2.265，95％CI 1.092-4.699）是30岁以上患者的独立预测因子。年轻患者的高度可疑甲状腺结节≤10毫米倾向于更具进展性。不同年龄患者的疾病进展预测因子是不同的。 © 2023年外科肿瘤学会。

The study aimed to identify the value and optimal age cutoff to predict the progression of highly suspicious thyroid nodules ≤ 10 mm during active surveillance (AS), and to reveal distinct risk factors in patients of different ages.A total of 779 patients with highly suspicious thyroid nodules were enrolled and followed up by ultrasonography. Locally weighted scatterplot smoothing (LOWESS) and the package 'changepoint' were used to identify the optimal age cutoffs using R. Multivariate Cox regression was performed to identify independent prognostic factors in each patient group divided according to age.Age was an independent predictor of nodule progression (P = 0.038). The optimal age cutoff to stratify the risk of nodule progression was 30 years. Younger patients were more likely to have progression of nodules during AS (P < 0.001), including enlargement of nodule size (P = 0.011) and new lesion occurrence (P < 0.001). Nodule size was identified as a risk factor for disease progression in patients younger than 30 years old (P = 0.008, OR 7.946, 95% CI 1.715-36.820), while multifocality (P = 0.018, OR 2.315, 95% CI 1.155-4.639) and thyroiditis (P = 0.028, OR 2.265, 95% CI 1.092-4.699) were independent predictors in patients over 30 years old.Highly suspicious thyroid nodules ≤ 10 mm in young patients tended to be more progressive. The predictors of disease progression were distinct in patients of different ages.© 2023. Society of Surgical Oncology.