无精子症患者睾丸系统针吸检查与组织病理检查的关系

目的探讨将睾丸系统针吸检查(SFNA)与组织病理检查相结合来预测睾丸中精子存在的可能性。方法67例无精子症患者先接受睾丸切开活检术及组织病理学检查,根据活检结果将患者分为梗阻性和非梗阻性无精子症(NOA),然后进行睾丸系统针吸检查及湿片镜检来发现精子的存在。结果67例患者中梗阻性无精子症12例,非梗阻性无精子症55例。所有患者的睾丸组织病理类型分为以下几种:正常精子生成、精子生成低下、生精阻滞、唯支持细胞综合征和混合型损害。行睾丸SFNA后,49％的NOA患者中发现精子,其中组织病理类型为精子生成低下的患者具有最高的精子获取率(95％)。结论对于无精子症患者而言,睾丸系统针吸检查是在睾丸中检测精子存在的有效方法;通过该方法检测到精子的可能性与睾丸组织病理类型有密切关系。

Correlation of testicular systematic fine needle aspiration with open testis biopsy histology in azoospermic men

Objective Investigating the relationship between systematic fine-needle aspiration and testis biopsy histology in predicting sperm presence in order to provide relative counseling to patient with azoospermia. Methods Firstly open testis biopsy was performed in 67 azoospermia men, including obstructive and nonobstructive azoospermia (NOA). Then all the patients underwent testicular systematic fine-needle aspiration (FNA), and wet preparation of the obtained testis tissue was investigated by microscopy to find spermatozoa. Results The numbers of obstructive azoospermia and NOA were 12 cases and 55 cases respectively. The testis histology patterns of total cases included normal spermatogenesis, hypospermatogenesis, sertoli cell-only, maturation arrest as well as mixed patterns that involved at least two of those histologies. Overall spermatozoa were found by systematic FNA in 49% of NOA patients. A comparison of histology and systematic FNA showed that the pattern of hypospermatogenesis had a higher rate of sperm detection. Conclusion For azoospermia patients systematic FNA is an effective, minimally invasive method to detect the sperm presence. Sperm detection by systematic FNA shows a close relationship with testis histology.