Flow cytometryによる睾丸内精子形成能の評価判定 第2報: 男子不妊症患者の精子形成能の評価

Abstract

男子不妊症患者42例, 精管結紮時の正常者5例の睾丸生検組織のDNA量分布をflow cytometryを用いて測定し, 組織学的評価法との関係を検討した.1)各症例とも従来の睾丸生検と同様の少量の組織片にて, 短時間で良好なDNAヒストグラムが得られた.2)ヒストグラムの各peakの面積を計算することによりhaploid, diploid, tetraploid cellの細胞比率が正確に算出された.3)正常群のhaploid, diploid, tetraploid cellの細胞比率は58.9±3.6%, 24.3±3.8%, 16.8±0.8%であった.4)ヒストグラムをhaploid cellのpeakの有無およびhaploid, tetraploid cellのpeakの大きさより, Type A:Aspermatogenesis without haploid cell, Type B:Maturation arrest at primary spermatocyte, Type C:Hypospermatogenesis, Type D:Normal spermatogenesisの4つのtypeに分類が可能であった.5)睾丸容量が小さくなるにしたがって, haploid cellの占める割合(%haploid)も小さくなり, 両者の間に有意な相関関係が認められた.6)%haploidとJohnsen's scoreおよび市川・熊本分類との関係を検討すると, %haploidは精子形成が障害されるにしたがって小さくなり, 精子形成能の定量的な指標になりうる

Flow cytometric DNA analysis was performed on the testicular biopsy tissue obtained from 17 oligospermic men, 25 azoospermic men and 5 normal men. DNA histograms were made after viewing a small piece of biopsy tissue for a short time. The DNA histograms were classified by eye into four types (Type A: Aspermatogenesis without haploid cell, Type B: Maturation arrest at primary spermatocyte, Type C: Hypospermatogenesis, Type D: Normal spermatogenesis). Analysis of the DNA histograms accurately revealed the proportion of haploid, diploid and tetraploid cells. The DNA distributions for 5 normal men were 58.9 +/- 3.6% haploid cells, 24.3 +/- 3.8% diploid cells and 16.8 +/- 0.8% tetraploid cells. Significant correlation was found between the proportion of haploid cells (%haploid) and the testicular volume. The results of the investigation of the correlation between the DNA distributions and histological evaluations show that testicular degeneration increase proportionally to the decrease in haploid cells. Therefore, the %haploid appears to be an effective index for the quantitative evaluation of spermatogenesis.