Department of Urology, Taipei Veterans General Hospital, No 201, Section 2, Shipai Rd, 112, Taipei, Taiwan.
Department of Physiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
J Assist Reprod Genet. 2023 May;40(5):1083-1088. doi: 10.1007/s10815-023-02764-5. Epub 2023 Mar 17.
To compare the diagnostic value of testicular tissue touch print smear (TPS) conducted on azoospermic patients with results obtained from histopathology and in vitro fertility (IVF) lab findings.
Microdissection testicular sperm extraction was performed on a group of 148 azoospermic patients and testicular samples obtained intraoperatively. Using TPS, the samples were smeared onto a sterile slide, followed with staining using thionine. The testis tissue bulk samples were also transferred to the IVF lab, and determinations of sperm presence or absence obtained from IVF lab tests were compared with the TPS sample results. Needle testis biopsy was separately performed on a group of 360 azoospermic patients, and results of pathohistology review on the biopsies were further compared with determinations of spermatogenesis stage obtained from TPS for those patients.
When compared with IVF lab results, TPS was found to have 100% (126/126) positive predictive value and 95.5% (25/26) negative predictive value for predicting sperm presence or absence, respectively. Furthermore, TPS was further found to have a 93.6% correlation (337 of 360 biopsies) with results of histological diagnoses performed by needle biopsy. Results from histology and TPS for the detection of sperm presence were concordant in 96.1% (346/360) of biopsies. Diagnosis of SCO by TPS shows the highest correlation with histopathology (98.6%), followed by complete spermatogenesis (97.5%), early maturation arrest (78.9%), and late maturation arrest (27.3%).
The results support the continued use of TPS in testicular tissue analysis for more rapid assessment of spermatogenesis and for detection of spermatozoa in azoospermic subjects.
比较睾丸组织触印涂片（TPS）在无精子症患者中的诊断价值与组织病理学和体外受精（IVF）实验室结果的相关性。
对 148 例无精子症患者进行了显微睾丸精子提取，并在手术中获得了睾丸样本。使用 TPS 将样本涂抹在无菌载玻片上，然后用硫堇染色。将睾丸组织大块样本转移到 IVF 实验室，比较 IVF 实验室检查中精子存在或不存在的结果与 TPS 样本结果。对另一组 360 例无精子症患者分别进行了睾丸活检，对活检的病理组织学检查结果进行了进一步比较，并对这些患者从 TPS 获得的生精阶段进行了评估。
与 IVF 实验室结果相比，TPS 对预测精子存在或不存在的阳性预测值分别为 100%（126/126）和 95.5%（25/26），阴性预测值分别为 100%（126/126）和 95.5%（25/26）。此外，TPS 与针吸活检的组织学诊断结果具有 93.6%的相关性（360 例活检中有 337 例）。TPS 和组织学检查在 96.1%（360 例活检中有 346 例）的活检中对精子存在的检测结果一致。通过 TPS 诊断 SCO 与组织病理学的相关性最高（98.6%），其次是完全生精（97.5%）、早期成熟阻滞（78.9%）和晚期成熟阻滞（27.3%）。
这些结果支持继续使用 TPS 进行睾丸组织分析，以便更快速地评估生精情况，并在无精子症患者中检测精子。
