Tenjin Tsuji Clinic, Fukuoka, Japan.
Ebisu Tsuji Clinic, Tokyo, Japan.
Fertil Steril. 2020 Jan;113(1):97-104.e2. doi: 10.1016/j.fertnstert.2019.08.061.
To investigate the value of the ultrasonographically determined size of seminiferous tubules and other conventional parameters for predicting sperm retrieval by microdissection testicular sperm extraction (micro-TESE).
Clinical retrospective study.
Two urological clinics.
PATIENT(S): Eight hundred six men with nonobstructive azoospermia.
INTERVENTION(S): Micro-TESE.
MAIN OUTCOME MEASURE(S): Sperm retrieval.
RESULT(S): Sperm retrieval was successful in 240 (29.8%) of the 806 men. In a receiver operating characteristic analysis of sperm retrieval, the area under the curve (AUC) for seminiferous tubules, assessed as 0, 100, 200, 250, or 300 μm, was no less than 0.82 (95% confidence interval [CI] 0.79-0.85). Sensitivity and specificity at a cutoff point of 250 μm were 76.7% and 80.7%, respectively. An AUC of 0.85 (95% CI, 0.81-0.88) was attained in a parsimonious multiple logistic regression model that included age (<30, 30-39, and 40-59 years), low follicle-stimulating hormone (<14 IU/L), history of cryptorchidism, and sex chromosome abnormality in addition to the diameter of seminiferous tubules.
CONCLUSION(S): The gray-scale image in testicular ultrasound was shown to be highly predictive of sperm retrieval in micro-TESE in a large series of men with nonobstructive azoospermia.
探讨经超声检测的生精小管直径和其他常规参数对经微切割睾丸精子提取术（micro-TESE）获取精子的预测价值。
临床回顾性研究。
两家泌尿科诊所。
806 名非梗阻性无精子症男性。
micro-TESE。
精子获取。
806 名男性中，240 名（29.8%）成功获取精子。在精子获取的受试者工作特征曲线分析中，生精小管的曲线下面积（AUC）评估为 0、100、200、250 或 300μm，均不小于 0.82（95%置信区间[CI] 0.79-0.85）。250μm 截断点的敏感性和特异性分别为 76.7%和 80.7%。在一个包含年龄（<30、30-39 和 40-59 岁）、低卵泡刺激素（<14IU/L）、隐睾病史和性染色体异常以及生精小管直径的简约多项逻辑回归模型中，AUC 为 0.85（95%CI，0.81-0.88）。
在一系列非梗阻性无精子症男性中，睾丸超声的灰阶图像显示对 micro-TESE 中精子获取具有高度预测价值。
