FNA精子获取失败预测模型对于当前术前进行风险筛查的非梗阻性无精子症个体是否有效？模型验证、高危人群识别及潜在替代精子获取探索。

Does the FNA sperm retrieval failure prediction model work well for current NOA individuals undertaking risk screening before the operation? Model validation, high-risk population identification and potential alternative sperm retrieval exploration.

作者信息

Jiang Xiaohui, Li Dingming, Zheng Yi, Li Yinxian, Bai Hengzhou, Zhao Guicheng, Zhang Yi, Ma Yue

机构信息

Human Sperm Bank, West China Second Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, 610041, China.

出版信息

BMC Med Inform Decis Mak. 2024 Dec 30;24(1):415. doi: 10.1186/s12911-024-02816-5.

DOI:10.1186/s12911-024-02816-5

PMID:39736733

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11686883/

Abstract

BACKGROUND

Non-obstructive azoospermia (NOA), the severe type of male infertility. The objective of this study was to evaluate the predictive accuracy of a prediction model of sperm retrieval failure with fine needle aspiration (FNA).

METHODS

This study involved 769 NOA patients (dataset 1) undertaking FNA and 140 NOA patients undertaking mTESE (dataset 2). The previous model was validated and then reconstructed for more potential risk factors and better accuracy in dataset 1. The reconstructed model was evaluated in NOA patients with different new variables. The outcomes of the micro- testicular sperm extraction (mTESE) were compared with the predicted outcomes of FNA to evaluate its potential as an alternative surgical sperm retrieval (SSR) technique.

RESULTS

307 (39.92%) males experienced sperm retrieval failure in FNA while 92 (65.7%) males experienced sperm retrieval failure in mTESE. The refined model has 80% overall agreement (n = 616). The reconstructed model had an AUROC of 0.876 (95% CI: 0.850-0.921). The mTESE has significantly higher success rate (34.29%) than the predicted success rate of FNA (5.71%).

CONCLUSIONS

Previous model shows good consistency. mTESE can be an alternative SSR method for NOA patients with a high predicted risk of sperm retrieval failure with FNA.

摘要

背景

非梗阻性无精子症（NOA）是男性不育的严重类型。本研究的目的是评估细针抽吸（FNA）预测精子获取失败模型的预测准确性。

方法

本研究纳入了769例接受FNA的NOA患者（数据集1）和140例接受显微睾丸精子提取术（mTESE）的NOA患者（数据集2）。对先前的模型进行验证，然后在数据集1中针对更多潜在风险因素和更高的准确性进行重建。在具有不同新变量的NOA患者中评估重建后的模型。将显微睾丸精子提取术（mTESE）的结果与FNA的预测结果进行比较，以评估其作为替代手术精子获取（SSR）技术的潜力。

结果

307例（39.92%）男性在FNA中经历了精子获取失败，而92例（65.7%）男性在mTESE中经历了精子获取失败。优化后的模型总体一致性为80%（n = 616）。重建后的模型AUROC为0.876（95% CI：0.850 - 0.921）。mTESE的成功率（34.29%）显著高于FNA的预测成功率（5.71%）。