Cortes D, Thorup J M, Lindenberg S
Department of Pediatric Surgery, University Hospital, Copenhagen, Denmark.
J Urol. 1996 Mar;155(3):1061-5. doi: 10.1016/s0022-5347(01)66392-4.
We investigated the prognostic value of the number of spermatogonia per tubular cross section in a testicular biopsy specimen obtained at orchiopexy for unilateral cryptorchidism.
A total of 87 consecutive 10 to 12-year-old cryptorchid boys underwent testicular biopsy simultaneously with unilateral orchiopexy. In adulthood 56 of the 87 patients agreed to measurement of serum follicle-stimulating hormone, luteinizing hormone, testosterone and testicular volume, and 54 provided specimens for semen analysis.
The number of spermatogonia per tubular cross section correlated to the volume of the operated testis and total testicular volume in adulthood. Serum follicle-stimulating hormone negatively correlated to these volumes, sperm concentration and total sperm count. Contralateral testicular volume correlated to sperm concentration, total sperm count, and percent of living and mobile sperm. When biopsy revealed Sertoli cells only or 1 spermatogonium per 100 tubular cross sections, the age matched number of spermatogonia per tubular cross section was 1% or less. Of these patients 33% later presented with 5 million spermatozoa per ml. or less, no normal motility and generally lower sperm concentrations that those with more than 1 spermatogonium per 100 tubular cross sections (greater than 1%) in the biopsy specimen. When the value was greater than 1%, later sperm quality was not significantly reduced in comparison to that of the general population.
The age matched number of spermatogonia per tubular cross section is significant in regard to fertility potential, and a value of 1% or less (approximately Sertoli cells only) may predict low fertility potential. To our knowledge Sertoli cells only have not been observed before 15 months of life, which makes it logical to treat cryptorchidism before this age even in unilateral cases.
我们研究了在单侧隐睾症睾丸固定术中获取的睾丸活检标本中，每个小管横截面上精原细胞数量的预后价值。
87名连续的10至12岁隐睾男孩在进行单侧睾丸固定术时同时接受了睾丸活检。成年后，87名患者中的56名同意测量血清卵泡刺激素、黄体生成素、睾酮和睾丸体积，54名提供了精液分析标本。
成年后，每个小管横截面上的精原细胞数量与手术侧睾丸体积和总睾丸体积相关。血清卵泡刺激素与这些体积、精子浓度和总精子数呈负相关。对侧睾丸体积与精子浓度、总精子数以及活精子和活动精子百分比相关。当活检显示仅存在支持细胞或每100个小管横截面上有1个精原细胞时，与年龄匹配的每个小管横截面上的精原细胞数量为1%或更低。这些患者中，33%后来精液每毫升含精子500万或更少，无正常活力，且精子浓度通常低于活检标本中每100个小管横截面上精原细胞超过1个（大于1%）的患者。当该值大于1%时，与普通人群相比，后期精子质量没有显著降低。
每个小管横截面上与年龄匹配的精原细胞数量对于生育潜力具有重要意义，1%或更低的值（大致仅为支持细胞）可能预示生育潜力较低。据我们所知，在15个月大之前未观察到仅存在支持细胞的情况，这使得即使在单侧病例中，在这个年龄之前治疗隐睾症是合理的。
