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目的:探讨乳头状甲状腺微小癌(PTMC)跳跃性侧颈淋巴结转移的临床风险因素，并建立临床预测模型。方法:回顾性分析2010年1月至2019年9月在浙江大学医学院附属杭州市第一人民医院集团住院并接受侧颈改良式淋巴结清扫的541例甲状腺乳头状癌(PTC)的临床病理资料，根据是否出现跳跃性侧颈淋巴结转移分为跳跃性转移组及非跳跃性转移组，采用统计分析的方法研究PTMC出现跳跃性侧颈淋巴结转移的临床危险因素，并建立数学模型、评价其预测价值。计量资料组间比较采用Wilcoxon检验；计数资料组间差异采用n χ2检验。n 结果:541例PTC中PTMC占30.68%(166例)，166例PTMC中共计174侧颈侧区淋巴结纳入研究，出现跳跃性侧颈淋巴结转移的概率为24.71%(43/174)。统计分析显示PTMC患者的初诊年龄>40岁、单侧病灶以及患侧中央区淋巴结清扫数<6枚与跳跃性侧颈淋巴结转移相关(Wals值分别为5.150、3.940、6.726，n P值均<0.05)，构建的数学模型(Y＝-2.915＋0.896×初诊年龄＋0.854×单双侧＋1.040×患侧中央区淋巴结清扫数)对预测PTMC出现跳跃性侧颈淋巴结转移的敏感性为86.05%，特异性为46.56%(n Z值＝4.970，n P40岁、单侧病灶、患侧中央区淋巴结清扫数目40 years), unilateral lesion and the number of lymph nodes (<6) dissected in the central region of the affected side (Wals were 5.150, 3.940 and 6.726, respectively,n P<0.05). The mathematical model (Y=-2.915+ 0.896×initial diagnosis age+ 0.854×unilateral bilateral+ 1.040×number of lymph nodes dissected in the central region of the affected side) of skip lateral cervical lymph node metastasis in PTMC. The sensitivity and specificity were 86.05% and 46.56% respectively (n Z=4.970, n P40 years, unilateral lesion and the number of lymph nodes (<6) dissected in the central region of the affected side were independent predictors of skip lateral cervical lymph node metastasis in PTMC, and the mathematical model has high predictive value.