摘要
目的:研究无精子症及隐匿精子症患者睾丸活检组织生精细胞类型及睾丸体积之间的关系。方法:收集来我院就诊的无精子症及隐匿精子症患者的完整睾丸活检病理报告,参照WHO《男性不育标准化诊疗手册》睾丸组织学分类方法进行分类,分析精液检查结果、睾丸组织学类型及睾丸体积之间的关系。结果:在492例患者中,无精子症占90.5%(445/492),隐匿精子症占9.5%(47/492)。生精小管内见成熟精子占17.9%(88/492)、生精小管内见生精细胞未见成熟精子占42.9%(211/492)、唯支持细胞综合征39.2%(193/492)。睾丸体积10ml及以下占38.6%(190/492),其中5ml及以下占7.9%(39/492)。生精小管内见成熟精子患者隐匿精子症检出率14.8%(13/88),生精小管内见生精细胞未见成熟精子患者隐匿精子症检出率11.4%(24/211),唯支持细胞综合征患者隐匿精子症检出率5.2%(10/193),唯支持细胞综合征患者隐匿精子症检出率显著下降(P<0.05)。结论:睾丸生精功能可能为局灶性,单次睾丸活检难以全面、完整反映睾丸生精功能状态。睾丸体积显著低于正常参考值仍会存在生精功能。睾丸活检适应证的掌握过于宽松。采用WHO的睾丸组织学分类方法,能更方便、更有效指导临床进一步检查及治疗方案。
Objective：To study the relationship between the testis volume and types of spermatogenic cells derived from testicular biopsy in patients with azoospermia or cryptozoospermia. Methods：We collected testicular pathological biopsies from 492 infertile patients with azoospermia or cryptozoospermia reported in our hospital,classified them according to the testicular histological classification methods in WHO Manual for Standardized Investigation,Diagnosis and Management of the Infertile Male,and analyzed the relationship of the testis volume with the results of semen analyses and testicular histology. Results：Of the 492 cases,90.5% （445/492） were azoospermia and 9.5% （47/492） cryptozoospermia; mature spermatozoa were present in the seminiferous tubules in 17.9% （88/492） but absent in 42.9% （211/492）,and Sertoli cell-only syndrome indicated in 39.2% （193/492）; the testis volume was ≤10 ml in 38.6% （190/492） and ≤5 ml in 7.9% （39/492）. Cryptozoospermia was detected in 14.8% （13/88） of those with mature spermatozoa in the seminiferous tubules,in 11.4% （24/211） of those without,and in 5.2% （10/193） of those with Sertoli cell-only syndrome,with a significantly lower rate in the latter group than in the former two （P 〈0.05）. Conclusion：Spermatogenesis of the testis may be focal and difficult to be completely reflected by a single testicular biopsy,and it may exist even if the testis volume is significantly below the reference value. The indications for testicular biopsy should not be improperly expanded. The WHO testicular histological classification methods have provided a convenient and effective guidance for further clinical examinations and establishment of a protocol.
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2010年第1期52-54,共3页
National Journal of Andrology
关键词
男性不育
无精子症
隐匿精子症
睾丸活检
唯支持细胞综合征
睾丸组织学
male infertility
azoospermia
cryptozoospermia
testicular biopsy
Sertoli cell-only syndrome
testicular histology
