Chinya Abhishek, Ratan Simmi K, Aggarwal Satish K, Garg Anju, Mishra T K
Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India.
Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India.
J Indian Assoc Pediatr Surg. 2017 Jan-Mar;22(1):3-8. doi: 10.4103/0971-9261.194609.
The aim of our study was to assess the association between reproductive hormones (inhibin B [inh B], follicle-stimulating hormone [FSH]) with testicular volume, echogenicity, and blood flow (resistive index [RI]) in children with undescended testis (UDT).
This was a prospective study of 1-year study duration.
A total of 33 patients (16 unilateral and 17 bilateral) UDTs aged 5-12 years with palpable UDT were included in the study. Morning fasting blood samples were taken for estimation of serum inh B and FSH as well as inh B/FSH ratio. Testicular ultrasound was done to compute testicular volume, testicular echogenicity, and testicular vascularity in terms of RI.
The mean age of patients enrolled in the study was 8.29 years for unilateral UDT and 7.97 years in bilateral UDT and it was comparable. The study groups were further subdivided into two age-wise subgroups school goers (5-8 years) and prepubertal (9-12 years). The values of inh B, FSH, and inh B/FSH ratios as well as mean testicular volume were comparable between both groups and subgroups. Overall mean testicular volume had a positive correlation with FSH, inh B, and inh B/FSH, but statistical significance was reached only for inh B ( < 0.001) in children with both unilateral and bilateral UDT. Apart from five patients with hypoechogenicity within the testis, all remaining testes were of homogenous echotexture with no instances of irregular echogenicity or tumor. Children with RI >0.6 were separately studied. The incidence of high RI (>0.6) was also comparable in unilateral or bilateral disease. These subjects had unfavorable biochemical parameters in terms of low inh B levels and high FSH levels.
Our findings hint to the fact that palpable UDT forms a homogenous group, whether unilateral or bilateral, whereas impalpable testes may form a separate category and need further studies to substantiate this hypothesis.
我们研究的目的是评估隐睾症（UDT）患儿生殖激素（抑制素B [inh B]、促卵泡生成素[FSH]）与睾丸体积、回声及血流（阻力指数[RI]）之间的关联。
这是一项为期1年的前瞻性研究。
本研究纳入了33例年龄在5至12岁、可触及隐睾的UDT患者（16例单侧隐睾和17例双侧隐睾）。采集早晨空腹血样以测定血清inh B、FSH以及inh B/FSH比值。进行睾丸超声检查以计算睾丸体积、睾丸回声及以RI表示的睾丸血管情况。
纳入研究的单侧UDT患者平均年龄为8.29岁，双侧UDT患者平均年龄为7.97岁，二者具有可比性。研究组进一步按年龄分为两个亚组：学龄儿童（5至8岁）和青春期前儿童（9至12岁）。两组及亚组之间inh B、FSH、inh B/FSH比值以及平均睾丸体积的值具有可比性。总体而言，平均睾丸体积与FSH、inh B及inh B/FSH呈正相关，但仅inh B在单侧和双侧UDT患儿中具有统计学意义（<0.001）。除5例睾丸内回声减低的患者外，其余所有睾丸均为均匀回声结构，无回声不规则或肿瘤情况。对RI>0.6的患儿进行了单独研究。单侧或双侧疾病中高RI（>0.6）的发生率也具有可比性。这些受试者在生化参数方面表现不佳，即inh B水平低而FSH水平高。
我们的研究结果提示，可触及的UDT，无论单侧或双侧，构成一个同质组，而不可触及的睾丸可能构成一个单独类别，需要进一步研究来证实这一假设。
