Lin J S, Lin Y M, Chow N H, Wang S T, Sun Y N
Department of Urology, Medical College, National Cheng Kung University, Tainan, Taiwan.
Urology. 2000 Feb;55(2):252-6. doi: 10.1016/s0090-4295(99)00410-0.
To objectively evaluate the contents of corpus cavernous tissue in impotent men using an automated novel image analysis system.
Thirty-three impotent men and 2 normal potent men (controls) underwent corpus cavernous biopsies. The procedures were performed using a Biopty gun under local anesthesia. The obtained specimens were stained with Masson's trichome technique, and the collagen fiber contents were evaluated by a computerized morphometric analysis method. In addition, we estimated the intraobserver and interobserver reliability of this automated image analysis system.
No major complication was noted during or after the biopsies. Of the 33 impotent patients, 3 were diagnosed as having psychogenic, 11 as having arteriogenic, 13 as having venogenic, 1 as having neurogenic, and 5 as having idiopathic impotence. The collagen fiber percentages in the 35 men were as follows: normal potent: 48.2% +/- 1.4%, psychogenic 55.2% +/- 11.6%, arteriogenic 73.2% +/- 4.4%, venogenic 66.5% +/- 4.2%, neurogenic 76.9%, and idiopathic 77.4% +/- 4.2%. Significant differences were found between the normal potent and arteriogenic groups (P <0.05) and between the normal potent and idiopathic groups (P <0.05). Patients older than 60 years had a higher collagen fiber content (70.4% +/- 3.7%) than those younger than 50 years old (58.6% +/- 5.2%). The interobserver and intraobserver variances were both negligible for this automated image analysis system. This method significantly reduced the amount of variation introduced by the intra-rater reliability of a technician compared with the manual method.
The present automated image analysis system is believed to be a reliable, accurate quantitative measurement tool for studies of penile tissue. Cavernous biopsy is a rapid, safe, and representative modality to study penile disease. An increase in cavernous collagen fibers (or corporal fibrosis) is considered an important factor in impaired erectile function.
使用一种新型自动化图像分析系统客观评估阳痿男性阴茎海绵体组织的成分。
33例阳痿男性和2例正常有勃起功能的男性（对照组）接受了阴茎海绵体活检。手术在局部麻醉下使用活检枪进行。获取的标本采用马松三色染色技术染色，胶原纤维含量通过计算机形态计量分析方法进行评估。此外，我们评估了该自动化图像分析系统在观察者内和观察者间的可靠性。
活检过程中及术后未发现重大并发症。33例阳痿患者中，3例诊断为精神性阳痿，11例为动脉性阳痿，13例为静脉性阳痿，1例为神经性阳痿，5例为特发性阳痿。35名男性的胶原纤维百分比情况如下：正常有勃起功能者为48.2%±1.4%，精神性阳痿者为55.2%±11.6%，动脉性阳痿者为73.2%±4.4%，静脉性阳痿者为66.5%±4.2%，神经性阳痿者为76.9%，特发性阳痿者为77.4%±4.2%。正常有勃起功能组与动脉性阳痿组之间（P<0.05）以及正常有勃起功能组与特发性阳痿组之间（P<0.05）存在显著差异。60岁以上患者的胶原纤维含量（70.4%±3.7%）高于50岁以下患者（58.6%±5.2%）。对于该自动化图像分析系统，观察者间和观察者内的差异均可忽略不计。与手动方法相比，该方法显著减少了技术人员观察者内可靠性所带来的变异性。
目前的自动化图像分析系统被认为是一种用于阴茎组织研究的可靠、准确的定量测量工具。海绵体活检是一种快速、安全且具有代表性的研究阴茎疾病的方式。海绵体胶原纤维增加（或海绵体纤维化）被认为是勃起功能受损的一个重要因素。
