Lu Jin-chun, Xu Hui-ru, Chen Fang, Huang Yu-feng
PLA Institute of Clinical Laboratory Medicine/Clinical School, Nanjing University Medical College, Nanjing General Hospital of Nanjing Command, Nanjing, Jiangsu 210002, China.
Zhonghua Nan Ke Xue. 2007 Jan;13(1):37-41.
To investigate and analyze the results of the determination of sperm concentration, fructose concentration, alpha-glucosidase and acid phosphatase (ACP) activities in the seminal plasma from different hospitals in the city of Nanjing, so as to provide a basis for the external quality control (EQC) of semen analysis within Jiangsu Province or even the whole country.
Eight samples of quality control products for low and high concentrations sperm count, fructose, alpha-glucosidase and ACP determination were prepared and divided, each detected for the sperm concentration, fructose, alpha-glucosidase and ACP activity, and the coefficient variances (CVs) were calculated. The products were then distributed to 11 hospitals in the city, and the results were collected and analyzed. In addition, the total relative errors (REs) for each product was calculated based on the results after dividing as reference values.
The CVs from the 8 samples after dividing were 3.83% - 11.16%. Collected from the 11 hospitals attending EQC were 11 reports of the results of sperm concentration, and 5 the results of fructose, alpha-glucosidase and ACP in seminal plasma. Among the results from different laboratories, those of fructose determination showed the minimal difference (CVs: 8.99% and 3.95% for low and high concentrations, respectively) , next came alpha-glucosidase (CVs: 16.66% and 18.41% for low and high activities, respectively), and ACP determination showed the maximal difference (CVs: 54.12% and 65.58% for low and high activities, respectively). Moreover, the same trend was observed in RE values, as shown in the total REs, which were 11.99% (low concentration) and 20.31% (high concentration) for the determination of fructose in seminal plasma, 22.92% and 27.26% for alpha-glucosidase, 7.34% and 318.35% for ACP in different laboratories, and the maximal RE value was detected in the result of the high-activity ACP sample. Of the 11 hospitals, 6 determined sperm concentration with the computer-assisted semen analysis (CASA) system, and the other 5 with the modified hemocytometer. RE values (148.47% and 187.59% for low and high concentration samples, respectively) and sperm concentrations ([62.74 +/- 16.63] x 10(6)/ml and [163.32 +/- 36.24] x 10(6)/ml) counted with the hemocytometer were significantly higher than those with the CASA system (REs 13.97% and 10.48%; sperm concentrations [24.88 +/- 4.16] x 10(6)/ml and [54.24 +/-23.06] x 10(6)/ml ).
The methods of seminal alpha-glucosidase and fructose determination were relatively stable in current andrology laboratories, and the variance range could be accepted. However, the method of seminal ACP determination might be unadaptable to clinical application, and needs to be further improved. Hemocytometer, which significantly overestimated sperm concentration, could not be applied to the assay of sperm concentration.
调查分析南京市不同医院精液中精子浓度、果糖浓度、α-葡萄糖苷酶及酸性磷酸酶（ACP）活性的检测结果，为江苏省乃至全国精液分析的室间质量控制（EQC）提供依据。
制备8份低、高浓度精子计数、果糖、α-葡萄糖苷酶及ACP检测的质量控制品，每份分别检测精子浓度、果糖、α-葡萄糖苷酶及ACP活性，并计算变异系数（CV）。然后将这些质控品分发给南京市11家医院，收集并分析结果。此外，根据分发后作为参考值的结果计算每个质控品的总相对误差（RE）。
8份质控品分发后的CV为3.83%～11.16%。从参与EQC的11家医院收集到11份精子浓度检测结果报告，5份精液中果糖、α-葡萄糖苷酶及ACP检测结果报告。不同实验室检测结果中，果糖检测结果差异最小（低、高浓度CV分别为8.99%和3.95%），其次是α-葡萄糖苷酶（低、高活性CV分别为16.66%和18.41%），ACP检测结果差异最大（低、高活性CV分别为54.12%和65.58%）。此外，RE值也呈现相同趋势，精液中果糖检测的总RE分别为11.99%（低浓度）和20.31%（高浓度），α-葡萄糖苷酶为22.92%和27.26%，不同实验室ACP检测的RE分别为7.34%和318.35%，高活性ACP样本检测结果的RE值最高。11家医院中，6家使用计算机辅助精液分析（CASA）系统检测精子浓度，另外5家使用改良血细胞计数板检测。用血细胞计数板计数的RE值（低、高浓度样本分别为148.47%和187.59%）和精子浓度（[ [62.74±16.63]×10⁶/ml和[163.32±36.24]×10⁶/ml）显著高于用CASA系统检测的结果（RE分别为13.97%和10.48%；精子浓度[24.88±4.16]×10⁶/ml和[54.24±23.06]×10⁶/ml）。
目前男科实验室精液α-葡萄糖苷酶和果糖的检测方法相对稳定，变异范围可接受。然而，精液ACP检测方法可能不适用于临床应用，需要进一步改进。血细胞计数板显著高估精子浓度，不能用于精子浓度检测。
