Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen 4032, Hungary.
Asian J Androl. 2009 Nov;11(6):741-5. doi: 10.1038/aja.2009.54. Epub 2009 Sep 28.
The purpose of this study was to investigate the effects of an elevated hydrostatic pressure of hydrocele on the structural integrity and steroid receptor expression pattern of the appendix testis in children. Twenty-six testicular appendages were obtained from boys (aged between 13 and 79 months, mean 40 months) who underwent surgical exploration because of hydrocele or congenital inguinal hernia. The tissue sections of testicular appendages were stained with hematoxylin-eosin. Immunohistochemistry and immunofluorescence laser microscopy were performed using monoclonal mouse anti-human receptors against androgen and estrogen receptors. Patients were divided into three groups: group A (n = 8) represented patients with groin hernia without hydrocele, who served as control group; group B (n = 7) represented patients with communicating hydrocele; and group C (n = 11) represented patients with noncommunicating hydrocele. The tissue sections of appendix testis expressed both androgen and estrogen receptors in all patients in groups A and B, and epithelial destruction was not present. The presence of androgen receptor (two of 11, P < 0.001) and estrogen receptor (four of 11, P = 0.006) was lower and the number of appendix testes with epithelial destruction was higher (eight of 11, P = 0.001) in group C. We demonstrated that groin hernia and communicating hydrocele did not influence the receptor expression pattern and the anatomic structure of testicular appendages, whereas noncommunicating hydrocele caused damage as indicated by the absence of steroid receptors and destruction of the epithelial surface. A better understanding of the physiological role of testicular appendages may change the indications of surgical treatment in patients with noncommunicating hydrocele.
本研究旨在探讨鞘膜积液升高的静水压力对儿童阑尾睾丸结构完整性和类固醇受体表达模式的影响。从因鞘膜积液或先天性腹股沟疝而接受手术探查的男孩（年龄 13 至 79 个月，平均 40 个月）中获得了 26 个睾丸附件。睾丸附件的组织切片用苏木精-伊红染色。使用针对雄激素和雌激素受体的单克隆抗人受体的免疫组织化学和免疫荧光激光显微镜检查进行。患者分为三组：A 组（n = 8）代表无鞘膜积液腹股沟疝患者，作为对照组；B 组（n = 7）代表交通性鞘膜积液患者；C 组（n = 11）代表非交通性鞘膜积液患者。A 组和 B 组所有患者的阑尾睾丸组织切片均表达雄激素和雌激素受体，且上皮无破坏。雄激素受体（11 例中的 2 例，P < 0.001）和雌激素受体（11 例中的 4 例，P = 0.006）的表达水平较低，上皮破坏的阑尾睾丸数量较高（11 例中的 8 例，P = 0.001）在 C 组中。我们证明腹股沟疝和交通性鞘膜积液不会影响受体表达模式和睾丸附件的解剖结构，而非交通性鞘膜积液则会导致类固醇受体缺失和上皮表面破坏，从而造成损伤。更好地了解睾丸附件的生理作用可能会改变非交通性鞘膜积液患者的手术治疗指征。
