Correlation between testicular biopsies (prepubertal and postpubertal) and spermiogram in cryptorchid men
Correlation between testicular biopsies (prepubertal and postpubertal) and spermiogram in cryptorchid men
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DOI：
10.1053/hupa.2000.16280
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发表时间：
2000-09-01
期刊：
影响因子：
3.3
通讯作者：
Paniagua, R
中科院分区：
文献类型：
--
作者：
Nistal, M;Riestra, ML;Paniagua, R
21名在婴儿期接受睾丸活检和睾丸固定术的年轻男性因不孕症再次进行活检。通过曲细精管的半定量研究比较这些患者的第一次和第二次活检标本，以评估生殖细胞的演变并将这些数据与精子数量相关联。根据平均小管直径和小管生育指数，将显示病变的婴儿睾丸分为3种类型：（1）轻度病变，（2）明显的生殖器发育不全，（3）严重的生殖器发育不全。在成年睾丸中，通过计算精原细胞、初级精母细胞、年轻精子细胞和成熟精子细胞的平均数量来评价精子发生。这些睾丸被分类为（1）正常;（2）近腔室有病变;（3）基底室有病变;和（4）混合性萎缩。通过幂回归曲线，将精子细胞的分化数量与射精中精子的预期数量相关。假设在生精小管中观察到的某些组织学病变表明排泄管阻塞：扩张、生精上皮的锯齿状轮廓、睾丸内精子囊肿、支持细胞的顶端细胞质空泡化和睾丸病变的镶嵌分布。青春期前病变和青春期后活检标本中精子发生程度之间存在相关性。40个睾丸的演变，不考虑其在婴儿期的位置（隐睾或阴囊）如下。14例组织学类型正常（5例睾丸）或轻微病变（9例睾丸）的婴儿睾丸演变为近腔室病变（8例睾丸）、混合性萎缩（4例睾丸）或基底和近腔室病变（2例睾丸）。6例睾丸明显发育不全者演变为混合性萎缩。20例重度睾丸发育不全的睾丸演变为混合性萎缩（17例睾丸）、仅支持细胞小管（2例睾丸）或基底室病变（1例睾丸）。在9例双侧（6例）或单侧（3例）阻塞的患者中，根据相关曲线预期的精子数远高于精子图中的实际精子数，这意味着许多无精子症男性的睾丸产生精子，这一发现证实了睾丸活检在不育研究中的重要性。Copyright（C）2000 by W.B.桑德斯公司
Twenty-one young men who underwent testicular biopsy and orchidopexy in infancy consulted owing to infertility and had biopsies again. The first and second biopsy specimens from these patients: were compared by means of a semiquantitative study of the seminiferous tubules to evaluate the evolution of germ cells and to correlate these data with spermatozoon numbers, The infant testes showing lesions were classified into 3 types according to the mean tubular diameter and tubular fertility index: (1) slight lesions, (2) marked germinal hypoplasia, and (3) severe germinal hypoplasia. Zn the adult testes, spermatogenesis was evaluated by calculating the average numbers of spermatogonia, primary spermatocytes, young spermatids, and mature spermatids, These testes were classified as (1) normal; (2) having lesions in the adluminal compartment; (3) having lesions in the basal compartment; and (4) mixed atrophy. The number of differentiated spermatids was correlated with the expected number of spermatozoa in the ejaculate by a power regression curve, The observation of certain histologic lesions in the seminiferous tubules was assumed to indicate excretory duct obstruction: ectasia, indented outline of the seminiferous epithelium, intratesticular spermatocele, apical cytoplasmic vacuolation of Sertoli cells, and mosaic distribution of testicular lesions. There was a correlation between the prepubertal:lesions and the degree of spermatogenesis in postpubertal biopsy specimens. The evolution of the 40 testes without regard to their location in infancy (crytorchid or scrotal) was as follows. The 14 infant testes with a normal histologic pattern (5 testes) or minor lesions (9 testes) evolved to testes with lesions of the adluminal compartment (8 testes), mixed atrophy (4 testes), or lesions of the basal and adluminal compartments (2 testes). The 6 testes with marked germinal hypoplasia evolved to testes with mixed atrophy. The 20 testes with severe germinal hypoplasia evolved to testes with mixed atrophy (17 testes), Sertoli-cell-only tubules (2 testes), or lesions in the basal compartment (1 testis). In the 9 patients with a histologic pattern of obstruction bilaterally (6 men) or unilaterally (3 men), the expected number of spermatozoa according to the correlation curve was much higher than the actual number in the spermiogram, This means that the testes of many azoospermic men produce spermatozoa, and this finding corroborates the importance of testicular biopsy in infertility studies. Copyright (C) 2000 by W.B. Saunders Company.