Yang Cheng, Li Jianxiong, Wu Shenghao, Liu Cundong, Zhou Ranran, Zhao Shan-Chao
Department of Urology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Transl Androl Urol. 2025 Feb 28;14(2):335-350. doi: 10.21037/tau-24-629. Epub 2025 Feb 25.
Not all varicocele (VC) patients experience improvements in semen quality after undergoing varicocelectomy. This study aims to investigate whether phosphoglycerate kinase 2 (PGK2) protein in seminal plasma could serve as a predictive biomarker for the enhancement of sperm motility post-varicocelectomy.
Sixty patients diagnosed with VC-associated asthenospermia and who underwent varicocelectomy at the Third Affiliated Hospital of Southern Medical University were included in this study. Semen samples from 33 healthy donors were also collected. Hematological and semen analysis parameters were assessed at baseline and at the 6-month postoperative follow-up. The concentration of PGK2 in seminal plasma was determined using enzyme-linked immunosorbent assay (ELISA). Additionally, eleven machine learning algorithms were employed to develop a model to evaluate the effectiveness of varicocelectomy based on PGK2 concentration, hematological parameters, and semen quality indicators.
The levels of PGK2 in seminal plasma were significantly lower in VC patients compared to healthy donors (P<0.001). Increased levels of PGK2 were observed in the VC subjects after the varicocelectomy (P<0.001). PGK2 concentration was found to be a significant indicator [area under curve (AUC) =0.735, 95% confidence interval (CI): 0.601-0.860] and an independent predictor (P=0.003, P=0.049) of the success of varicocelectomy. The linear discriminant analysis (LDA) model demonstrated strong classification ability for assessing varicocelectomy outcomes in both the training (AUC =1.000, 95% CI: 1.000-1.000) and testing (AUC =0.804, 95% CI: 0.619-0.963) groups.
PGK2 in seminal plasma shows promise as a potential biomarker for predicting improved sperm motility following varicocelectomy, thus aiding in clinical decision-making regarding therapeutic approaches.
并非所有精索静脉曲张（VC）患者在接受精索静脉结扎术后精液质量都会改善。本研究旨在探讨精浆中的磷酸甘油酸激酶2（PGK2）蛋白是否可作为预测精索静脉结扎术后精子活力增强的生物标志物。
本研究纳入了60例在南方医科大学第三附属医院被诊断为VC相关性弱精子症并接受精索静脉结扎术的患者。还收集了33名健康供者的精液样本。在基线和术后6个月随访时评估血液学和精液分析参数。使用酶联免疫吸附测定（ELISA）法测定精浆中PGK2的浓度。此外，采用11种机器学习算法建立一个模型，以基于PGK2浓度、血液学参数和精液质量指标评估精索静脉结扎术的有效性。
与健康供者相比，VC患者精浆中PGK2水平显著降低（P<0.001）。精索静脉结扎术后VC患者的PGK2水平升高（P<0.001）。发现PGK2浓度是精索静脉结扎术成功的显著指标[曲线下面积（AUC）=0.735，95%置信区间（CI）：0.601-0.860]和独立预测因子（P=0.003，P=0.049）。线性判别分析（LDA）模型在训练组（AUC =1.000，95% CI：1.000-1.000）和测试组（AUC =0.804，95% CI：0.619-0.963）中均显示出强大的评估精索静脉结扎术结果的分类能力。
精浆中的PGK2有望作为预测精索静脉结扎术后精子活力改善的潜在生物标志物，从而有助于临床治疗方法的决策。
