无精子症病人精液细胞学与睾丸针吸细胞学检查的相关性研究

６１例无精子症病人精液细胞学与睾丸针吸细胞学研究的结果显示，８７％的病人精液中检出生精细胞，精液细胞学与睾丸针吸细胞学检查总符合率为９１％（梗阻性无精子症除外）；经ｘ＾２检验二者显著相关（Ｐ〈０．００５），同一病人两种检查所反映的生精细胞发育水平一致。提示精液细胞学检查能反映睾丸生精状况，是一种比较理想的无创伤检查方法。     

精液、睾丸针吸细胞学与睾丸活检的相关性

对两组病例，第１组６１例无精子症病人，进行精液细胞学与睾丸针吸细胞学检查；第２组１５例正常生育男性及４例无精子症病人，进行睾丸活检与精液细胞学检查。结果显示：第１组５３例（占８７％，５３／６１）精液中检出生精细胞，检出病例中精液细胞学与睾丸针吸细胞学所反映的生精细胞发育水平总符合率为９１％，经Ｘ２检验二者显著相关（Ｐ＜０．００５）；８例（占１３％）精液细胞学检查未见生精细胞的病例，考虑梗阴性无精子症，其中７例经精液生化指标证实，５例睾丸针吸细胞检查见精子。第２组两种方法所反映的生精细胞发育水平完全一致。说明精液细胞学检查既能很好反映睾丸生精状况，又能反映精道梗阴情况，是一种比较理想的判断睾丸生精功能及精道梗阻的无创伤性检查方法。     

精液,睾丸针吸细胞学与睾丸活检的相关性

对两组病例，第１组６１例无精子症病人，进行精液细胞学与睾丸针吸细胞学检查，第２组１５例正常生育男性及４例无精子症病人，进行睾丸活检与精液细胞学检查，结果显示，第１组５３例（占８７，５３／６１）精液中检出生精细胞，检出病例中精液细胞学与睾丸针吸细胞学所反是央的生精细胞发育水平总符合率为９１％，经Ｘ＾２检验二者显著相关（Ｐ〈０．００５）；８例（占１３％）精液细胞学检查未见生精细胞的病例，考虑梗阻性无精     

精液细胞学与睾丸活检及针吸细胞学的相关性研究

为了寻找无创伤性判断睾丸生精功能及精道梗阻的检查方法，对６５例无精症患者随机分为两组：第一组６１例无精子症患者，进行精液细胞学与睾丸针吸细胞学检查；第二组１５例正常生育男性及４例无精子症患者，进行睾丸活检与精液细胞学检查。结果：第一组５３例（占８７％），精液中检出生精细胞，检出病例二者的生精细胞发育水平总符合率９１％，经χ２检验两者呈显著相关（Ｐ＜０．００５）；８例（占１３％）精液细胞学检查未见生精细胞的病例，考虑梗阻性无精子症，其中７例经精液生化指标证实，５例睾丸针吸细胞检查见精子。第二组两种方法所反映的生精细胞发育水平完全一致。说明精液细胞学检查既能很好反映睾丸生精状况，又能反映精道梗阻情况，是一种比较理想的判断睾丸生精功能及精道梗阻的无创伤性检查方法。     

替代睾丸活检的新方法——精液细胞学研究

目的：寻找无创伤判断睾丸生精功能及输精管道梗阻的检查方法。方法：对１２２例无精子症病人及５０例生育男性同时进行睾丸活检和精液细胞学检查。结果：生育男性精液细胞学及睾丸活检生精细胞发育水平符合率为１００％,无精子症病人总符合率为９１％;经Ｋａｐｐａ检验两法呈高度相关,Ｐ＜０．０１。１４例睾丸活检见精子及各级生精细胞,精液细胞学检查未见生精细胞的病例,经精液生化指标证实１３例为输精管道梗阻,１例为逆行射精。结论：两种方法所反映的生精细胞水平完全一致,说明精液细胞学检查是一种比较理想的判断睾丸生精功能及输精管道梗阻的无创伤检查方法     

替代睾丸活检的新方法——精液细胞学研究

目的：寻找无创伤判断睾丸生精功能及输精管道梗阻的检查方法。方法：对１２２例精子症病人及５０例生育男性同时进行睾丸活检和精液细胞学检查。结果;生育男性精液细胞学及睾丸活检生精细胞发育水平符合率为１００％,无精子症病人总符合率为９１％;经Ｋａｐｐａ检验两法呈高度相关,Ｐ〈０．０１。１４例睾丸活检见精子及各级生精细胞,精液细胞学检查未见生精细胞的病例,经精液生化指标证实１３例为输精管道梗阻,１例为逆行射     

无精子症病人性激素测定和精液细胞学检查

目的：对无精子症病人进行血清性激素和精液细胞学分析。方法：45例无精子症病人采用放射免疫法（RIA）检测性激素，瑞－吉染色法进行精液细胞学检查。结果：45例无精子症病人中，未检出生精细胞者29例，血清T值降低14例（31．1％），FSH，LH升高18例（28．9％），PRL升高4例（8．9％）。结论：睾丸体积减小，T值降低，FSH和LH升高，提示睾丸功能损害，并且T／LH值更能反映睾丸间质细胞的功能，血清PRL只有在诊断高泌乳素血症引起的无精子症中才有意义。血清性激素测定和精液细胞学检查在鉴别非梗阻性与梗阻性无精子症是一项重要指标，对判定睾丸功能的损害程度和指导临床治疗有重要意义。     

精液生精细胞检查鉴别诊断无精子症

近年来 ,用精液生精细胞来评价睾丸生精功能 ,特别是用于鉴别诊断梗阻性与原发性无精子症的研究受到人们的关注[1,2 ] 。研究认为 ,同一病人精液生精细胞检查结果与睾丸活检所反映的细胞发育水平相一致 ,并认为是替代睾丸活检的理想方法[1] 。本文以精液细胞学结合精浆生化指标对 4 6例无精子症的发生类型和睾丸生精功能进行了观察。旨在进一步研究探讨生精细胞学检查在鉴别诊断无精子症中的意义。1　材料与方法1 1　研究对象　来我院男科门诊的无精子症不育病人 4 6例 ,均经 3次以上精液常规检查证实 ,年龄2 3～ 31岁 ,不育史 1～ 8年 ,性…     

Y染色体微缺失不育患者精液细胞学观察

目的:对Y染色体AZF区域微缺失不育患者进行精液细胞学检查,从而评估其生精功能。方法:收集35例AZF缺失不育患者,年龄23~44岁,经3次以上精液常规分析证实,26例为非梗阻性无精子症,9例为严重少精子症。按照AZF缺失部位分为以下4组进行观察:AZFa+b+c区域缺失组5例,AZFb+c缺失(4例)及单独AZFb缺失(3例)组7例,AZFc缺失组23例。采集患者精液,待自然液化后离心,生理盐水洗涤2次,离心沉淀物经生理盐水稀释后涂于干净玻片上,瑞吉染色,光学显微镜下观察。对其中6例患者进行了睾丸组织病理学检查。结果:AZFa+b+c缺失组,精液细胞学检查均未见各级生精细胞,可见少量上皮细胞。其中1例经睾丸活组织病理学检查,生精小管中未见各级生精细胞,为唯支持细胞综合征,与精液细胞学检查结果一致。AZFb+c缺失及单独AZFb缺失组,精液细胞学检查其中6例细胞停滞在精母细胞阶段,2例睾丸活检见生精阻滞在初级精母细胞阶段。1例AZFb缺失的患者精液细胞学检查见初级精母细胞、次级精母细胞和精子细胞,但睾丸活检显示阻滞在精母细胞阶段。AZFc缺失组中,少精子症组(8例)患者生精细胞检查5例停滞在精母细胞阶段,见少量精子细胞,另3例未见各级生精细胞;无精子症组(15例)患者未见各级生精细胞,其中2例经睾丸活检,证实为唯支持细胞综合征。结论:精液细胞学检查对AZF缺失患者能有效评估生精功能,作为一项无创检查技术,容易被患者接受,推荐作为临床评估生精功能的一项方法。     

睾丸细针穿刺吸液细胞学检查诊断阻塞性无精子症

目的 :观察睾丸细针穿刺吸液 ( FNA)细胞学检查的效果 ,为诊断阻塞性无精子症提供新的诊断方法。方法 :2 86例无精子症患者采用睾丸 FNA细胞学检查结合精浆生化指标测定及输精管造影对睾丸生精功能及阻塞部位进行诊断 ;以 42例精子密度在正常范围 ( 2 5～ 86× 1 0 6 / ml)的成年男性作为对照组。 2 4例做钳穿活检进行自身对照。结果 :( 1 )双侧输精管未触及者 58例 ,睾丸 FNA细胞学检查生精功能正常 2 6例 (可见较多生精细胞、精子细胞及精子 )、生精功能低下 2 4例、无生精功能 8例 ,精浆果糖在正常值范围 ,而肉毒碱及α-糖苷酶明显低于正常值范围 ;( 2 ) 3 2例睾丸 FNA细胞学检查见较多精子 ,精液沉渣涂片未见生殖细胞 ,其中 6例精浆果糖、肉毒碱及 α-糖苷酶明显低于正常值范围 ,结合输精管造影确诊为射精管阻塞 ,其余 2 6例精浆果糖在正常值范围 ,而肉毒碱及α-糖苷酶明显低于正常值范围 ,确诊为附睾尾部阻塞性无精子症 ;( 3 )睾丸生精功能极度低下或无生精功能 1 96例 ,其中 1 60例仅见各级生精细胞、精子细胞和支持细胞 (睾丸生精功能阻滞 ) ,3 6例仅见支持细胞 (唯支持细胞综合征 ) ,精浆果糖、肉毒碱及 α-糖苷酶均在正常值范围 ,为非阻塞性无精子症。结论 :睾丸 FNA细胞学检查可作为阻塞性无?     

The role of fine-needle aspiration cytology of the testis in the diagnostic evaluation of infertility.

OBJECTIVE: To compare the diagnostic value of cytological smears of fine-needle aspirate with that of histological sections obtained by testicular biopsy in the evaluation of infertility. PATIENTS AND METHODS: The study included 60 patients with azoospermia or severe oligospermia (sperm counts of < 5 million/mL). A detailed history was taken and the external genitalia examined. Testicular samples were obtained by fine-needle aspiration using a 10 mL syringe and 21 G needle; the air-dried smears were stained using the May-Grunwald-Giemsa method. A testicular biopsy was taken after exploring the same tract and these sections were stained with haematoxylin and eosin. The cytological smears and histological sections were examined separately and the results compared. RESULTS: The cytological smears were divided into three groups: normal, with all spermatogenic cells present; Sertoli-cell only syndrome; and spermatogenic arrest (all spermatogenic cells present except spermatids and spermatozoa). There was a good correlation between the diagnosis on the cytological smears and histological sections in 58 of 60 patients (97%). In two patients there was scanty aspirate and few cells, giving an inaccurate diagnosis. Interstitial cells were not detected on cytological smears. In three patients, Sertoli-cell only was diagnosed on cytology, and histology revealed additional features of Leydig cell hyperplasia. CONCLUSION: Fine-needle aspiration of the testis is a simple and minimally invasive technique for diagnostic evaluation, especially in patients with obstructive azoospermia. Patients with abnormal findings on fine-needle aspiration cytology may be evaluated histologically by further biopsy.     

Detection rate of histologically insignificant prostate cancer with systematic sextant biopsies and fine needle aspiration cytology

PURPOSE: We evaluate the detection rate of insignificant prostate cancer and the rate of significant prostate cancer overlooked in the results of systematic sextant biopsy and fine needle aspiration biopsy of the prostate of asymptomatic men with serum prostate specific antigen concentrations less than 4.0 ng./ml. MATERIALS AND METHODS: We analyzed specimens from 133 consecutive patients with a mean age of 60 years undergoing cystoprostatectomy for bladder cancer. Six systematic biopsy specimens and 2 fine needle aspiration cytology samples were taken from the prostate immediately after cystoprostatectomy. The specimens were step sectioned and examined for prostate cancer. Insignificant prostate cancer was defined as any cancer with an aggregate volume 0.5 cm.3 or less. RESULTS: Incidental prostate cancer was found in 58 of the 133 patients (44%). Tumor volume was 0.5 cm.3 or less in 47 cases. Sextant biopsy detected 7 cancers, including 4 of 47 (9%) that were insignificant and 3 of 11 (27%) that were significant. Fine needle aspiration cytology also detected 7 cancers, including 3 (6%) and 4 (36%) that were insignificant and significant, respectively. CONCLUSIONS: Systematic sextant biopsy and fine needle aspiration cytology each diagnose prostate cancer in about 5% of asymptomatic men who have normal digital rectal examination and serum prostate specific antigen less than 4.0 ng./ml. However, many of the cancers thus detected are insignificant and most of the significant cancers are missed. Therefore, routine screening of such patients with sextant biopsy or aspiration cytology does not appear to be justified.     

精液生精细胞检查与男科疾病

目的：探讨精液生精细胞检查与疾病的关系。方法：采用瑞-姬染色法观察精液生精细胞形态、数量及存在比例。结果：化疗、放疗病人出现生精细胞形态异常；长期服用雷公藤药物生精停滞于初级精母细胞阶段；长期接触高温、肾功能不全而行血透者生精细胞停滞于初级精母细胞及精子细胞阶段；双侧隐睾及Klinefelter综合征病人精液中无精子及生精细胞；阴囊鞘膜积液约20％的病人生精停滞于精子细胞阶段；精索静脉曲张（Ⅱ～Ⅲ°）精液中以精子细胞为主；睾丸及附睾炎症病人精液中除出现次级精母细胞、精子细胞外，以中性粒细胞、淋巴细胞、单核巨噬细胞多见。结论：本研究为精液常规检查增加了新内容，为诊断与治疗不育症及环境遗传因索引起的生精障碍，提供了客观指标。     

Use of fine needle aspiration cytology for the diagnosis of testicular relapse in patients with acute lymphoblastic leukemia

The testis frequently is the site of relapse in male patients with acute lymphoblastic leukemia. While many patients with testicular involvement by acute lymphoblastic leukemia have enlarged or firm testes, clinical examination alone is insufficient to establish or exclude the diagnosis completely. Open biopsy generally has been used to document the presence of acute lymphoblastic leukemia. However, this procedure requires general anesthesia and hospitalization. We studied 11 patients with a history and/or physical findings suspicious for testicular acute lymphoblastic leukemia relapse to determine the efficacy of fine needle aspiration cytology in the evaluation of the testes for leukemic infiltration. Of the 11 patients fine needle aspiration cytology correctly identified all 5 patients with histologically proved testicular acute lymphoblastic leukemia, it was negative in 5 with no histological evidence of leukemia and it demonstrated rare atypical cells that were not evident on subsequent histological examination in 1. No adverse effects were encountered in this series. Fine needle aspiration cytology appears to be a safe, reproducible alternative to open biopsy in the evaluation of patients for testicular relapse of acute lymphoblastic leukemia.     

术前诊断为胰腺癌术中细针穿刺细胞学检查阴性结果病例分析

目的 探讨术前诊断为胰腺癌术中细针穿刺细胞学（FNAC）检查阴性结果病例的临床意义和提高诊断准确性的方法。方法 回顾性分析1995年12月至2006年6月中国协和医科大学肿瘤医院术前诊断为胰腺癌，术中FNAC结果阴性的33例病人的临床特点、影像表现、实验室检查结果和随访资料。结果33例均获得随访，时间3个月至8年，其中30例为真阴性病例，肿物为慢性肿决型胰腺炎所致；3例为假阴性病例，术后出现肿决增大，肿瘤多发转移。结论慢性胰腺炎（CP）是出现阴性结果的主要因素，肿瘤体积大小、生长方式和术者取材技术决定FNAC的准确性。应提高对慢性胰腺炎临床特点的认识及术前诊断的准确性，改进穿刺取材和制片技术可以降低假阴性率。     

The complementary role of fine needle aspiration cytology and Tru-cut needle biopsy in the management of breast masses

Fine needle aspiration cytology (FNA) and Tru-cut needle biopsy (TNB) have been used for the pre-operative diagnosis of cancer in breast masses as alternatives to open breast biopsy. The accuracy of clinical examination, fine needle aspiration biopsy and Tru-cut needle biopsy was assessed in 230 patients with palpable breast masses and the value of using both biopsy methods in the management was prospectively evaluated. Clinical diagnosis had a sensitivity of 89.2% and specificity of 78.4% (32.7% false positive, 6.5% false negative). Aspiration cytology was diagnostic in 78.4% of cancers and 71.6% of benign lesions [excluding non-diagnostic samples (27.4%), sensitivity was 96.6% and specificity was 100%]. Tru-cut needle biopsy identified 82.9% of cancers and 61.7% of benign lesions [excluding non-diagnostic samples (33.3%), sensitivity was 96.7% and specificity was 100%]. There were no false positive errors with either aspiration cytology or needle biopsy. Statistical comparison showed that there was no significant difference between aspiration cytology and needle biopsy. The combined result of both biopsies was superior to clinical examination when non-diagnostic samples were excluded. With the routine use of both biopsy techniques, frozen section was avoided in 73% of all cancers and unnecessary operations were avoided in 33.5% of patients which included breast cysts, benign mammary dysplasia and inflammatory lesions.     

Fine‐needle aspiration cytology of parotid tumours: Is it useful?

Background : The efficacy of fine‐needle aspiration cytology (FNAC) in the diagnosis of parotid tumours remains a controversial subject. Studies within small departments utilizing experienced pathologists have shown FNAC to have high sensitivity and specificity for parotid tumours. The present study was performed to assess the accuracy and utility of FNAC of parotid tumours within a teaching hospital environment. Methods : One hundred and sixty‐nine patients underwent both FNAC and subsequent surgery to the parotid between 1995 and 1999. The results of the FNAC were compared to the histopathological diagnosis obtained from the surgical specimen. Results : Fine‐needle aspiration cytology had an overall accuracy of 56%. Approximately 10% of the FNAC results were non‐diagnostic. The sensitivity and specificity for the following diagnoses were, respectively: benign 86% and 61%; malignant 57% and 100%; pleomorphic adenoma 78% and 95%; squamous cell carcinoma 52% and 99%; mucoepidermoid carcinoma 14% and 99% and adenocarcinoma 20% and 100%. Six non‐neoplastic conditions were misdiagnosed and all six patients underwent surgery. Conclusions : Fine‐needle aspiration cytology was found to be highly specific for malignancy but its sensitivity for malignancy was poor. The results show that although FNAC is relatively inexpensive and minimally invasive, it cannot be relied upon to provide an accurate tissue diagnosis, may fail to identify malignancy and does not prevent patients undergoing surgery for non‐neoplastic conditions.