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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。
Objective To explore the possibility of predicting the presence of spermatozoa in testis by combining the testicular system needle aspiration (SFNA) with histopathological examination. Methods Sixty-seven patients with azoospermia received testicular biopsy and histopathology. According to the results of biopsy, the patients were divided into obstructive and non-obstructive azoospermia (NOA), and then testicular needle aspiration and wet sheet Microscopic examination to find the presence of sperm. Results 67 cases of obstructive azoospermia in 12 cases, non-obstructive azoospermia in 55 cases. The histopathological types of testis in all patients were classified into the following categories: normal spermatogenesis, low sperm production, spermatogenic arrest, only support for cell syndrome and mixed lesions. Spermatozoa were found in 49% of patients with NOA after testicular SFNA, with the highest rate of sperm acquisition (95%) in patients with histopathological types of low sperm production. Conclusion For patients with azoospermia, testicular needle aspiration test is an effective method to detect the presence of sperm in testes. The possibility of detecting sperm by this method is closely related to testicular histopathology.