标题：无精症患者睾丸穿刺活检的临床病理类型及意义

      作者：朱文标 1，黄政城 2，卢善明 1    (梅州市人民医院病理科 1、生殖医学科 2，广东 梅州 514031)

      卷次： 2018年29卷20期

      【摘要】 目的 探讨无精症睾丸穿刺活检的病理类型及临床意义。方法 回顾性分析2004年3月至2018年1月在梅州市人民医院生殖医学科就诊并行睾丸穿刺活检的 102例男性无精症患者的睾丸活检组织切片，依据主要病理组织学特征进行病理分型，并对在梅州市人民医院接受自体辅助生殖治疗的患者的受孕情况进行随访分析。结果 依据主要病理组织学特征，无精症睾丸穿刺活检病理类型可分为输出道阻塞型[7.8% (8/102)]、生精功能低下型[53.9% (55/102)]、成熟障碍型[20.6% (21/102)]、唯支持细胞综合征型[17.7% (18/102)]。17例接受辅助生殖治疗，辅助生殖方法为睾丸取精卵泡内单精子注射，5例因非医学原因取消移植，受孕9例，占75.0% (9/12)；临床妊娠并成功分娩7例，占58.3% (7/12)；流产2例，占16.7% (2/12)；未受孕3例，占25.0% (3/12)。结论 睾丸穿刺病理检查是无精症患者诊疗中非常有价值的检查。依据主要病理特征可以将无精症睾丸活检分为4种临床病理类型，有利于无精症睾丸活检的规范化病理诊断，便于临床应用及研究。
      【关键词】 无精症；睾丸活检；临床病理类型；临床意义
      【中图分类号】 R698 【文献标识码】 A 【文章编号】 1003—6350（2018）20—2847—03

Clinicopathological type of testicular biopsy in azoospermia and the clinical significance.
ZHU Wen-biao 1, HUANGZheng-cheng 2, LU Shan-ming 1. Department of Pathology 1, Department of Reproductive Medicine 2, Meizhou People'sHospital, Meizhou 514031, Guangdong, CHINA
【Abstract】 Objective To investigate the pathological type and clinical significance of testicular biopsy in pa-tients with azoospermia. Methods The testicular biopsies of 102 male azoospermia patients, who admitted to Depart-ment of Reproductive Medicine of Meizhou People's Hospital from March 2004 to January 2018, were retrospectivelyanalyzed. The pathological types were classified according to the prominent histopathological characteristics. The preg-nancy rate of patients receiving self-assisted reproductive therapy in our hospital was followed up. Results The clinico-pathological types of testicular biopsy in azoospermia can be divided into 4 types by prominent pathological changes: ob-structive type (7.8%, 8/102), hypospermatogenic type (53.9%, 55/102), spermatogenic arrest (20.6%, 21/102) and Sertolicell-only syndrome (SCOS) type (17.7%, 18/102). There were 17 couples undergoing assisted reproductive treatment inour hospital, including 5 couples canceled transplantation beyond medical factors. Follicle intracytoplasmic sperm injec-tion was performed successfully in 12 couples, and 9 couples were fertilized, accounting for 75.0% (9/12); 7 couples werebred successfully, accounting for 58.3% (7/12); 2 couples were aborted, accounting for 16.7% (2/12); 3 couples were failedto be fertilized, accounting for 25.0% (3/12). Conclusion The pathological examination of testicular puncture is a valu-able examination in the diagnosis and treatment of azoospermia. According to the prominent pathological changes, testicu-lar biopsy of azoospermia can be divided into 4 clinical pathological types, which is conducive to the standardized patho-logical diagnosis of testicular biopsy for azoospermia, and is convenient for clinical application and research.
      【Key words】 Azoospermia; Testicular biopsy; Clinicopathological type; Clinical significance·论 著·doi:10.3969/j.issn.1003-6350.2018.20.011