Jung Jay Ho, Lee Tae Ho, Choi Kyung Hwa, Hong Jae Yup
Department Urology, Bundang CHA Hospital, CHA University, Seongnam, Korea.
Chonnam Med J. 2017 Sep;53(3):211-215. doi: 10.4068/cmj.2017.53.3.211. Epub 2017 Sep 25.
To evaluate the diagnostic efficacy of needle aspiration biopsy of seminiferous tubules (NABST) and to represent the redistributed diagnostic results corresponding to testicular volumes and follicle-stimulating hormone (FSH) levels. In this retrospective study, we investigated 65 infertile men with either azoospermia or oligoasthenoteratozoospermia. Following NABST, specimens were stained with hematoxylin and eosin and classified into five histological types. With pre-procedure FSH levels and testicular volumes, we evaluated the probabilities of detecting sperms within biopsy specimens. NABST led to the classification of normal spermatogenesis in 31 cases (47.7%), hypospermatogenesis in 23 cases (35.4%), maturation arrest in 4 cases (6.2%), and Sertoli cell only syndrome in 4 cases (6.2%). The success rate of reaching a histological diagnosis using NABST was 95.4% (62 out of 65 cases). Fourteen patients (21.5%) had a testicular volume <15 cc; of these, 8 patients (57.1%) had normal spermatogenesis, 2 patients (14.3%) had hypospermatogenesis, 2 patients (14.3%) had maturation arrest and 2 patients (14.3%) had Sertoli cell-only syndrome (SCO). Twelve patients (18.5%) had an FSH level ≥10 IU; of these, 6 (50%) had normal spermatogenesis, 2 patients (16.7%) had maturation arrest and 4 patients (33.3%) had SCO. Cases with an FSH level <10 IU were positively associated with a probability of detecting sperm using NABST (p<0.001). NABST is a reliable tool for the histological diagnosis of azoospermic and oligoasthenoteratozoospermic patients. The diagnostic success rate was high and associated with pathological accuracy. NABST is a convenient procedure with few complications.
评估生精小管针吸活检(NABST)的诊断效能,并呈现与睾丸体积和卵泡刺激素(FSH)水平相对应的重新分布的诊断结果。在这项回顾性研究中,我们调查了65名患有无精子症或少弱畸精子症的不育男性。NABST后,标本用苏木精和伊红染色,并分为五种组织学类型。根据术前FSH水平和睾丸体积,我们评估了在活检标本中检测到精子的概率。NABST导致31例(47.7%)正常精子发生、23例(35.4%)精子发生低下、4例(6.2%)成熟停滞和4例(6.2%)唯支持细胞综合征的分类。使用NABST达成组织学诊断的成功率为95.4%(65例中的62例)。14名患者(21.5%)睾丸体积<15 cc;其中,8名患者(57.1%)精子发生正常,2名患者(14.3%)精子发生低下,2名患者(14.3%)成熟停滞,2名患者(14.3%)患有唯支持细胞综合征(SCO)。12名患者(18.5%)FSH水平≥10 IU;其中,6名(50%)精子发生正常,2名患者(16.7%)成熟停滞,4名患者(33.3%)患有SCO。FSH水平<10 IU的病例与使用NABST检测到精子的概率呈正相关(p<0.001)。NABST是无精子症和少弱畸精子症患者组织学诊断的可靠工具。诊断成功率高且与病理准确性相关。NABST是一种方便的操作,并发症少。