Hadziselimovic F, Leibundgut B, Da Rugna D, Buser M W
J Urol. 1986 Apr;135(4):707-10. doi: 10.1016/s0022-5347(17)45826-5.
With the use of semi-thin sections of 88 testicular biopsies from 44 patients, we were able to separate a relatively uniform group of patients with idiopathic left varicocele and infertility into 4 groups with different pathophysiological conditions. Group 1 patients had atrophy of the Leydig cells, decreased Leydig cell ratio, low plasma testosterone, and normal luteinizing and follicle-stimulating hormone levels. Surgery resulted in a significant improvement in sperm count. Group 2 patients had undergone attempted repair of Leydig cells, and had a normal Leydig cell ratio, and normal testosterone, luteinizing hormone and follicle-stimulating hormone plasma values. Group 3 patients demonstrated hyperplasia and an increased Leydig cell ratio, high luteinizing and follicle-stimulating hormone values, and relatively high testosterone values. Group 4 patients had an increased Leydig cell ratio but severe atrophy of the Leydig cells and tubuli, indicating burned out testes with high luteinizing and follicle-stimulating hormone but low testosterone levels. A successful operation failed to increase the sperm count in the latter groups. The technique used should allow better patient selection for medical treatment, as well as lead to a better understanding of the etiopathogenesis of infertility in varicocele patients. Therefore, the histological technique has an important role in the evaluation of patients suffering from infertility in general.
通过对44例患者的88份睾丸活检半薄切片进行分析，我们能够将患有特发性左侧精索静脉曲张并伴有不育症的一组相对同质的患者，分为4组具有不同病理生理状况的患者。第1组患者存在Leydig细胞萎缩、Leydig细胞比例降低、血浆睾酮水平低，而黄体生成素和卵泡刺激素水平正常。手术使精子数量有显著改善。第2组患者的Leydig细胞曾尝试修复，Leydig细胞比例正常，睾酮、黄体生成素和卵泡刺激素的血浆值也正常。第3组患者表现为Leydig细胞增生且比例增加，黄体生成素和卵泡刺激素值高，睾酮值相对较高。第4组患者Leydig细胞比例增加，但Leydig细胞和曲细精管严重萎缩，表明睾丸已衰竭，黄体生成素和卵泡刺激素水平高但睾酮水平低。对于后几组患者，成功的手术未能增加精子数量。所采用的技术应有助于更好地选择适合药物治疗的患者，也有助于更好地理解精索静脉曲张患者不育症的病因发病机制。因此，组织学技术在评估一般不育症患者中具有重要作用。
