Nagata Yuko, Fujita Kazuyuki, Banzai Junichi, Kojima Yumi, Kasima Katsunori, Suzuki Mina, Tanaka Kenichi
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
J Obstet Gynaecol Res. 2005 Oct;31(5):384-8. doi: 10.1111/j.1447-0756.2005.00306.x.
The value of serum inhibin-B as a predictor of the presence of testicular spermatozoa is still controversial. The purpose of this study is to evaluate the predictive value of the seminal plasma inhibin-B level, which might more directly reflect the secretion by Sertoli cells, and to discriminate between successful and failed testicular sperm extraction (TESE) in non-obstructive azoospermia.
Sixty-two patients with non-obstructive azoospermia were examined at the Department of Obstetrics and Gynecology at Niigata University Hospital, Niigata, Japan. The level of inhibin-B was measured using a two-site enzyme-linked immunoassay.
Testicular sperm were successfully retrieved in 17 of 62 patients (27.4%). The serum levels of follicle-stimulating hormone (FSH) were significantly lower and the serum and seminal inhibin-B concentrations were significantly higher in the successful TESE group compared with the failed TESE group. According to the receiver operating characteristics (ROC) curve analysis, the best discriminating seminal plasma inhibin-B level was 27.0 pg/mL (sensitivity 88.2%, specificity 93.3%). The best discriminating serum inhibin-B level was 34.0 pg/mL (sensitivity 70.6%, specificity 95.6%). The area under the ROC curve for seminal plasma inhibin-B was significantly larger than that for FSH and testicular volume. Using multivariate logistic regression analysis, only seminal plasma inhibin-B was an independent predictor of the presence of spermatozoa on TESE.
Seminal plasma inhibin-B level is a useful predictor of the presence of testicular sperm in men with non-obstructive azoospermia.
血清抑制素B作为睾丸精子存在的预测指标，其价值仍存在争议。本研究旨在评估精浆抑制素B水平的预测价值，该指标可能更直接地反映支持细胞的分泌情况，并区分非梗阻性无精子症患者睾丸精子提取（TESE）的成功与失败。
日本新潟大学医院妇产科对62例非梗阻性无精子症患者进行了检查。采用双位点酶联免疫吸附测定法测量抑制素B水平。
62例患者中有17例成功获取睾丸精子（27.4%）。与TESE失败组相比，成功组的血清卵泡刺激素（FSH）水平显著降低，血清和精浆抑制素B浓度显著升高。根据受试者工作特征（ROC）曲线分析，区分精浆抑制素B的最佳水平为27.0 pg/mL（敏感性88.2%，特异性93.3%）。区分血清抑制素B的最佳水平为34.0 pg/mL（敏感性70.6%，特异性95.6%）。精浆抑制素B的ROC曲线下面积显著大于FSH和睾丸体积的ROC曲线下面积。使用多因素逻辑回归分析，只有精浆抑制素B是TESE时精子存在的独立预测指标。
精浆抑制素B水平是预测非梗阻性无精子症男性睾丸精子存在的有用指标。
