Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
Chin Med J (Engl). 2012 Aug;125(16):2885-9.
It is still controversial whether the serum inhibin B level is a superior predictor of the presence of sperm in testicular sperm extraction (TESE) in azoospermic men compared with serum follicle-stimulating hormone (FSH). In this study, we evaluated the diagnostic accuracy of serum inhibin B levels as a predictor of the outcome of TESE in Chinese non-obstructive azoospermic men and compared it with the traditional marker serum FSH and testicular volumes.
Basal values of serum hormone levels, testicular volumes and histological evaluation of 305 Chinese non-obstructive azoospermic men were analyzed. The level of inhibin B was measured using a three-step enzyme-linked immunoassay before sperm extraction, and the diagnostic accuracy of prediction of the outcome of TESE was compared for different markers by the receiver operating characteristics (ROC) curve analysis.
Testicular sperm was successfully retrieved in 137 of 305 patients (44.9%). The serum level of inhibin B, the FSH and the testicular volume were significantly different between the successful TESE group and the unsuccessful group. According to the ROC curve analysis, for inhibin B, the cut-off value for discriminating between successful and failed TESE was 28.39 pg/ml (sensitivity 83.5%, specificity 79.1%). For FSH, the best cut-off value for discriminating was 11.05 pg/ml (sensitivity 83.5%, specificity 74.5%). The area under the ROC curve of serum inhibin B was similar to that of FSH. Combining the serum inhibin B with FSH levels did not improve the predictive value for successful TESE.
Serum inhibin B and FSH levels are correlated with spermatogenesis. However, inhibin B is not superior to FSH in predicting the presence of sperm in TESE. And the combination of them does not improve the diagnostic accuracy on TESE outcome.
与血清卵泡刺激素（FSH）相比，血清抑制素 B 水平是否能更好地预测睾丸精子提取（TESE）中无精子症患者精子的存在仍存在争议。在这项研究中，我们评估了血清抑制素 B 水平作为预测中国非梗阻性无精子症男性 TESE 结果的诊断准确性，并将其与传统标志物血清 FSH 和睾丸体积进行了比较。
分析了 305 例中国非梗阻性无精子症男性的基础血清激素水平、睾丸体积和组织学评估值。在精子提取前使用三步酶联免疫吸附法测量抑制素 B 水平，并通过接收者操作特征（ROC）曲线分析比较不同标志物预测 TESE 结果的诊断准确性。
305 例患者中有 137 例（44.9%）成功提取睾丸精子。成功 TESE 组和不成功组之间血清抑制素 B、FSH 和睾丸体积水平差异显著。根据 ROC 曲线分析，对于抑制素 B，区分成功和失败 TESE 的截断值为 28.39 pg/ml（灵敏度 83.5%，特异性 79.1%）。对于 FSH，最佳截断值为 11.05 pg/ml（灵敏度 83.5%，特异性 74.5%）。血清抑制素 B 的 ROC 曲线下面积与 FSH 相似。联合血清抑制素 B 和 FSH 水平并不能提高 TESE 成功预测的价值。
血清抑制素 B 和 FSH 水平与精子发生相关。然而，抑制素 B 在预测 TESE 中精子的存在方面并不优于 FSH。并且它们的组合并不能提高 TESE 结果的诊断准确性。
