Thorup Jorgen, Kvist Kolja, Clasen-Linde Erik, Hutson John M, Cortes Dina
Department of Pediatric Surgery, Rigshospitalet, Copenhagen, Denmark; Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark.
Department of Pediatric Surgery, Rigshospitalet, Copenhagen, Denmark.
J Urol. 2015 May;193(5):1632-6. doi: 10.1016/j.juro.2014.10.110. Epub 2014 Nov 11.
Boys with cryptorchidism have overall increased gonadotropin and decreased serum inhibin B levels compared to normal. Serum inhibin B levels, produced by Sertoli cells, may reflect the state of germinative epithelium in cryptorchid testes. We evaluated whether serum inhibin B levels differed between boys with unilateral vanished testis and those with unilateral cryptorchidism.
Blood samples from 297 boys 1.5 to 5 years old were included, of whom 222 had unilateral cryptorchidism, 29 had unilateral vanished testis and 46 had undergone unilateral orchiopexy 1 year previously. Serum inhibin B levels were measured using a commercially available ELISA kit and were compared to normal range.
Serum inhibin B levels in boys with unilateral vanished testis were not different from those with unilateral cryptorchidism. Serum inhibin B values were above the normal median in 43% of boys previously operated on for unilateral cryptorchidism, compared to 17% at surgery (p = 0.0003). The percentage of patients with inhibin B levels below normal range was 14% in those with unilateral vanished testis, 23% in those with unilateral cryptorchidism and 11% in those who had undergone orchiopexy 1 year previously for unilateral cryptorchidism. The percentage of boys with inhibin B levels above normal median was 24% in those with unilateral vanished testis, 17% in those with unilateral cryptorchidism and 43% in those who had undergone orchiopexy. However, in boys with a vanished testis the frequency of serum inhibin B above normal median was only 5% before age 1.5 years, after which the rate was 67% (p = 0.0022).
Our findings may reflect the development of contralateral testicular hypertrophy in boys with unilateral vanished testis. The initial low inhibin B values may be explained by impaired total number of Sertoli cells. Serum inhibin B values also indicated that in 6-month to 5-year-old boys with cryptorchidism orchiopexy was beneficial for the germinative epithelium.
与正常男孩相比，隐睾症男孩的促性腺激素总体升高，血清抑制素B水平降低。由支持细胞产生的血清抑制素B水平可能反映隐睾睾丸中生发上皮的状态。我们评估了单侧睾丸缺如男孩与单侧隐睾症男孩的血清抑制素B水平是否存在差异。
纳入297名1.5至5岁男孩的血样，其中222名患有单侧隐睾症，29名患有单侧睾丸缺如，46名在1年前接受了单侧睾丸固定术。使用市售酶联免疫吸附测定（ELISA）试剂盒测量血清抑制素B水平，并与正常范围进行比较。
单侧睾丸缺如男孩的血清抑制素B水平与单侧隐睾症男孩无异。在先前接受过单侧隐睾症手术的男孩中，43%的血清抑制素B值高于正常中位数，而手术时这一比例为17%（p = 0.0003）。单侧睾丸缺如患者中抑制素B水平低于正常范围的百分比为14%，单侧隐睾症患者为23%，1年前因单侧隐睾症接受睾丸固定术的患者为11%。抑制素B水平高于正常中位数的男孩百分比在单侧睾丸缺如患者中为24%，单侧隐睾症患者中为17%，接受睾丸固定术的患者中为43%。然而，在睾丸缺如的男孩中，1.5岁之前血清抑制素B高于正常中位数的频率仅为5%，之后这一比例为67%（p = 0.0022）。
我们的研究结果可能反映了单侧睾丸缺如男孩对侧睾丸肥大的发展情况。最初较低的抑制素B值可能是由于支持细胞总数受损所致。血清抑制素B值还表明，在6个月至5岁患有隐睾症的男孩中，睾丸固定术对生发上皮有益。
