• 作者： 張心湜; 邱文祥; 江宏; 李良明; 陳明村
• 作者服務機構： 國立陽明醫學院外科學科; 國立陽明醫學院病理學科; 臺北榮民總醫院外科部泌尿外科; 臺北榮民總醫院病理部
• 中文摘要： 自民國七十八年七月起，總共有十一例原發性男性不孕症及七例可孕男性接受睪丸活體切片，其中四例為輸精管結紮病患，另外三例為攝護腺癌病患之睪丸切除，共計三十六例睪丸接受流動細胞圖形儀分析(Flow Cytometer)。其中二例失敗，其餘三十四例之睪丸流動細胞圖形皆可發現特殊變化。在正常精子生成功能之病例中(Normal Spermatogenesis)，單套細胞(1C)占了大多數的細胞族群，然後是雙套細胞(2C)及四套細胞(4C)。精子生成功能低下症患者中(Hypospermatogenesis)，其細胞族群之比例分布為2C＞1C＞4C。精子成熟障礙(Maturation Arrest）之患者其細胞族群之比例為2C＞4C＞1C。至於Sertoli-cell-only Syndrome之患者，其雙套細胞占了大多數的族群。 依據以上診斷要點，以此三十四睪丸切片之細胞流動圖形與病理切片做比較。吾人發現，其中二十八例之細胞流動圖形與資深病理醫師之切片診斷吻合(82.6%)。然僅有二十例之資淺醫師病理診斷與資深醫師相吻合(55.6%)。由此發現睪丸病理切片之診斷須長時間之經驗及訓練。再者，利用流動細胞圖形儀來診斷睪丸精子生成功能為一診斷率相當高之檢查工具；並且其所需之標本數也比傳統病理切片減少甚多。男性不孕症患者之精子生成功能，睪丸細胞流動圖形是一客觀及準確之檢查。
• 英文摘要： From January to July 1989, the DNA histogram of testicular open biopsies was done for 11 patientsof primary infertility and 7 patients of a control group. There were 2 failures in these 36 specimens. Theflow cytometric analysis revealed characteristic patterns in the relative numbers of haploid (1C), diploid(2C), and tetraploid (4C) cells. In the presence of normal spermatogenesis, the haploid compartment con-tained the majority of cells, followed by the diploid, and then the tetraploid (1C>2C>4C). The otherdiagnostic criteria of flow cytometry were as follows: hypospermatogenesis (2C>1C>4C), the maturationarrest (2C>4C>1C), and Sertoli-cell-only syndrome (2C, near 100%). According to the aforementioneddiagnostic criteria, the results of DNA histograms were compared with the histopathology diagnosed byjunior or senior pathologists. These patterns of DNA histograms correlated with the diagnoses by seniorpathologists in 28 of 34 specimens (82.6%), while there were only 20 of 36 pathologic diagnoses (55.6%)which matched between junior and senior pathologists. It is shown that abundant experience is needed fortestis pathologists to diagnose accurately. The DNA histograms correlate well with pathological findings,with the advantages of quantification and fewer specimens needed. In conclusion, testicular tubular cellDNA histograms appear to be a reliable modality in the evaluation of spermatogenesis. They provide thequantitative information of sperm maturation and help in making appropriate decisions in the managementof male infertility.
• 中文關鍵字： histopathology; DNA histogram; testicular biopsy.
• 英文關鍵字： --