Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis.
Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis.
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FSH、睾丸体积和组织病理学结果对非梗阻性无精子症显微切割 TESE 取精率的预测价值：一项荟萃分析
DOI：
10.4103/aja.aja_5_17
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发表时间：
2018-01
影响因子：
2.9
通讯作者：
Wang T
中科院分区：
文献类型：
--
作者：
Li H;Chen LP;Yang J;Li MC;Chen RB;Lan RZ;Wang SG;Liu JH;Wang T
我们进行这项荟萃分析，以评估不同参数对非梗阻性无精症（NOA）患者显微切割睾丸精子提取（TESE）取精率（SRR）的预测价值。所有相关研究均在 PubMed、Web of Science、EMBASE、Cochrane Library 和 EBSCO 中检索。我们选择了三个参数来进行荟萃分析：促卵泡激素（FSH）、睾丸体积和睾丸组织病理学结果，其中包括三种模式：精子生成不足（HS）、成熟停滞（MA）和仅支持细胞综合征（SCOS）。如果存在阈值效应，则仅计算汇总受试者工作特征曲线下面积 (AUSROC)。此外，还计算了汇总敏感性、特异性、阳性似然比 (PLR)、阴性似然比 (NLR) 和诊断比值比 (DOR)。最终我们的研究纳入了二十一篇文章。调查 FSH 和 SCOS 的研究存在阈值效应。 FSH、睾丸体积、HS、MA 和 SCOS 的 AUSROC 分别为 0.6119、0.6389、0.6758、0.5535 和 0.2763。睾丸体积、HS 和 MA 的 DOR 分别为 1.98、16.49 和 1.26。它们的敏感性分别为0.80、0.30和0.27，而特异性分别为0.35、0.98和0.76。它们的PLR分别为1.49、10.63和1.15。 NLR 分别为 0.73、0.72 和 0.95。我们研究中所有调查因素的预测价值有限。然而，组织病理学结果在一定程度上有帮助。大多数 HS 患者可以通过显微解剖 TESE 获得精子。
We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (TESE) in patients with nonobstructive azoospermia (NOA). All relevant studies were searched in PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO. We chose three parameters to perform the meta-analysis: follicle-stimulating hormone (FSH), testicular volume, and testicular histopathological findings which included three patterns: hypospermatogenesis (HS), maturation arrest (MA), and Sertoli-cell-only syndrome (SCOS). If there was a threshold effect, only the area under the summary receiver operating characteristic curve (AUSROC) was calculated. Otherwise, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the diagnostic odds ratio (DOR) were also calculated. Twenty-one articles were included in our study finally. There was a threshold effect among studies investigating FSH and SCOS. The AUSROCs of FSH, testicular volume, HS, MA, and SCOS were 0.6119, 0.6389, 0.6758, 0.5535, and 0.2763, respectively. The DORs of testicular volume, HS, and MA were 1.98, 16.49, and 1.26, respectively. The sensitivities of them were 0.80, 0.30, and 0.27, while the specificities of them were 0.35, 0.98, and 0.76, respectively. The PLRs of them were 1.49, 10.63, and 1.15, respectively. And NLRs were 0.73, 0.72, and 0.95, respectively. All the investigated factors in our study had limited predictive value. However, the histopathological findings were helpful to some extent. Most patients with HS could get sperm by microdissection TESE.