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目的:探讨年轻上尿路尿路上皮癌（upper tract urothelial carcinoma， UTUC）患者的临床病理特征与预后的关系。方法:回顾性分析1999年9月至2019年9月在北京大学第三医院接受肾-输尿管根治术治疗的839例UTUC患者的临床病理资料，以年龄55岁为界分为年轻组（<55岁，107例）和中老年组（≥55岁，732例）。经倾向评分匹配校正组间资料平衡后，按1∶1比例对患者进行匹配。比较两组患者临床病理特点及预后差异。结果:年轻组男性患者多于女性（n P=0.047），多有吸烟史（n P=0.042），年轻组有肾移植病史的患者显著多于中老年组（n P0.05）。年轻组的女性UTUC患者的肿瘤特异性生存期（n P=0.034）和无病生存期（n P=0.046）显著少于中老年组的女性患者。神经侵犯（肿瘤特异性生存率n P=0.002，无病生存率n P<0.01）和伴大片坏死（肿瘤特异性生存率n P=0.041，无病生存率n P=0.001）是年轻患者术后生存的独立预后因素。n 结论:年轻组与中老年组UTUC在性别、有无吸烟史、有无肾移植病史及首发症状上存在较大差异。年轻组的女性UTUC患者术后生存情况比中老年组的女性患者差。临床医师可参考肿瘤有无神经侵犯和伴大片坏死来评估年轻UTUC患者的预后。“,”Objective:To investigate the clinicopathological characteristics and prognosis of the young patients with upper tract urothelial carcinoma (UTUC).Methods:The clinical data of 839 UTUC patients receiving radical nephroureterectomy at Peking University Third Hospital, Beijing, China from September 1999 to September 2019 were retrospectively analyzed. The patients were divided into the young (<55 years old, 107 cases) and elderly groups (≥55 years old, 732 cases). After the variables were balanced using propensity score matching, the patients were paired at a 1∶1 ratio. The clinicopathological characteristics and survival rates were compared between the two groups.Results:Compared with the elderly group, the young group had more males (n P=0.047), a higher rate of smoking history (n P=0.042), a higher rate of renal transplantation history (n P0.05). Young female patients had shorter CSS (n P=0.034) and DFS (n P=0.046) than elderly females. Perineural invasion (CSS, n P=0.002; DFS, n P<0.01) and extensive necrosis (CSS,n P=0.041; DFS, n P=0.001) were the independent risk factors of survival in young patients.n Conclusions:Young UTUC patients are different from elderly ones in the frequencies of gender, smoking history, renal transplantation history, and first symptoms. Young female patients have a worse prognosis than elderly female ones. Perineural invasion and extensive necrosis could help clinicians to evaluate the prognosis of young UTUC patients.