原因不明少精子症睾丸生精细胞增殖与凋亡变化的研究

Study on changes of proliferation and apoptosis of spermatogenic cell in idiopathic oligospermia

目的 探讨原因不明少精子症睾丸生精细胞增殖与凋亡的病理生理机制。 方法 4 1例原因不明少精子症患者行睾丸穿刺活检 ,所取睾丸组织采用免疫组化技术观察生精细胞增殖细胞核抗原 (PCNA)及 p16的表达 ;采用原位 3′羟基末端标记法 (ISEL)观察生精细胞凋亡。 5例正常睾丸作为对照。 结果 原因不明少精子症患者睾丸生精细胞PCNA增殖指数 (2 1.6± 13.1) % ,明显低于对照组的 (45 .4± 5 .7) % ,P <0 .0 0 1;p16蛋白表达阳性率 (18.5± 8.9) % ,明显高于对照组的 (7.2± 2 .4 ) % ,P <0 .0 1;生精细胞凋亡指数 (1.7± 1.2 ) % ,明显高于对照组的 (0 .2± 0 .1) % ,P <0 .0 1,差别均有显著性意义。 结论 原因不明少精子症患者精子减少的主要原因之一是生精细胞增殖能力减少及凋亡增加造成增殖与凋亡平衡失调 ,此种失衡可能与 p16蛋白的异常表达有关。

Objective To investigate the pathophysiological mechanism of proliferation and apoptosis in spermatogenic cell of idiopathic oligospermia. Methods Forty one patients with oligospermia were included in the trial.Testicular tissues,which were obtained with Tru Cut needle biopsy,were observed under light microscope.Expressions of p16 and PCNA,incidence of apoptosis in spermatogenic cells were detected by immunohistochemistry and in situ 3′ DNA end labeling technique. Five testicular samples which were proved to be normal by examination served as controls. Results Proliferation index (21.6±13.1)% in testes of patients was lower than the normal controls (45.4±5.7)%, P <0.001.Expressions of p16 ( 18.5 ± 8.9 )% and apoptosis index (1.7±1.2)% in testes of patients were higher than the normal controls ( 7.2 ± 2.4 )% and (0.2±0.1)%,respectively,both P <0.01. Conclusions The present study indicates that one of the main causes of oligospermia results from lower proliferation and higher apoptosis of spermatogenic cell,which are related to abnormal expression of p16.