替代睾丸活检的新方法——精液细胞学研究

Comparative evaluation of semen cytology and biopsy of testis in diagnosis of male infertility

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。

Objectives: To study a non-traumatic examinative method which can estimate the function of testis and the blockage of seminiferous tubules. Methods: 122 cases of azoospermia and 50 of fertilizable men were detected with biopsy and semen cytological methods simultaneously Results: The correspondence of the results which detected with the two methods in fertilizable group was 100%,in the azoospermia group was 91%.The corresponding Kappa statistic being 0. 905 for the comparison between the two methods(P<0.01).Examinated with testicular biopsy in 14 patients,we can find sperms and all stages of the spermatogenic cells,however,we can't find any spermatogenic cells with semen cytology.The 13 cases among the foregoing 14 patients were demonstrated blockage of seminiftrous tubules with semen biochemical examination. Conclusions: The kappa statistic showed fair agreement between the two methods.The semen cytology examination is one of the perfect non-traumatic methods to estimate the function of testis and th e blockage of seminiferous tubules.