ABSTRACT
Non-obstructive azoospermia (NOA), which is defined as the absence of spermatozoa in the ejaculate secondary to impaired spermatogenesis within the testis, may be caused by a variety of etiologies, including varicocele-induced testicular damage, cryptorchidism, prior testicular torsion, post-pubertal mumps orchitis, gonadotoxic effects from medications, genetic abnormalities, chemotherapy/radiation, and other unknown causes currently classified as idiopathic (Cocuzza et al., 2013). The microdissection testicular sperm extraction (micro-TESE) technique involves a meticulous microsurgical exploration of the testicular parenchyma to identify and selectively extract larger seminiferous tubules that carry a higher probability of complete spermatogenesis (Schlegel, 1999). The Cornell group evaluated the efficacy of micro-TESE in 152 NOA patients with an associated history of cryptorchidism. In their series, spermatozoa were successfully retrieved in 116/181 attempts (64%), and the resulting pregnancy rate was 50% with a delivery rate of 38% (Dabaja and Schlegel, 2013). Franco et al. (2016) described a stepwise micro-TESE approach in NOA patients, which was considered to reduce the cost, time, and effort associated with the surgery. Alrabeeah et al. (2016) further reported that a mini-incision micro-TESE, carried through a 1-cm equatorial testicular incision, can be useful for micro-TESE candidates, particularly in patients with cryptozoospermia. We conducted a retrospective study of 20 consecutive NOA patients with a history of orchidopexy from May 2015 to March 2017.
Subject(s)
Adult , Humans , Male , Middle Aged , Azoospermia/surgery , Microdissection/methods , Orchiopexy , Retrospective Studies , Sperm RetrievalABSTRACT
<p><b>OBJECTIVE</b>To explore the value of combined assay of serum PG and OPN concentration for gastric cancer screening.</p><p><b>METHODS</b>Pepsinogen I , II and osteopontin (OPN) concentrations in fasting serum were measured by ELISA in 570 subjects, including 144 gastric cancer, 60 dysplasia, 113 atrophic gastritis, 70 erosion or ulcer, 92 superficial gastritis and 91 healthy control. The cut off point for PG and OPN was determined using receiver operator characteristics curves (ROC).</p><p><b>RESULTS</b>Using a serum PG I concentration < or =80 ng/ml, I: II ration < or =5.0 and OPN concentration > or =34 ng/ml or > or =30.4 ng/ml (based on ROC) for gastric cancer screening,the specificity, positive and negative predictive values were superior to that obtained by PG concentration only. Using a serumPGI concentration < or =50 ng/ml, I : II ration C 5. 0 and OPN concentration > or =35.2 ng/ml or > or =29. 2 ng/ml (based on ROC), the sensitivity, positive and negative predictive values were superior to that obtained by PG concentration only. Combining PG and OPN for gastric cancer screening, both sensitivity and specificity were more than 70% , while with OPN alone, only good specificity can be achieved.</p><p><b>CONCLUSION</b>Combining different serum PG and OPN concentration for gastric cancer screening is superior to PG or OPN only. This may be used as a new method in gastric cancer mass screening.</p>
Subject(s)
Humans , Gastritis, Atrophic , Blood , Diagnosis , Mass Screening , Methods , Osteopontin , Blood , Pepsinogen A , Blood , Pepsinogen C , Blood , Precancerous Conditions , Blood , Diagnosis , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , Stomach Neoplasms , Blood , Diagnosis , Stomach Ulcer , Blood , DiagnosisABSTRACT
Objective To determine the serum level of pepsinogenⅠ,Ⅱ(PGⅠ,PGⅡ) and PGⅠ/Ⅱin the residents from Zhuanghe county,a high risk area of gastric cancer in North China,and to explore their distribution as well as related factors.Methods Serum PGⅠand PGⅡlevels were detec- ted with ELISA method in 6990 subjects.Gastric diseases were diagnosed by endoscopy and histopatho- logic examination.Serum H.pylori-IgG antibody was determined by ELISA method.Results The me- dian values for PGⅠ,PGⅡ,PGⅠ/Ⅱwere 86.9/?g/L,10.6/zg/L and 8.1 respectively.Serum PGⅠand PGⅡin male(95.2?g/L,12.1?g/L) were significantly higher than those in female(79.7?g/L, 9.4?g/L;P=0.000),PGⅠ/Ⅱratio(7.9) was significantly lower in male (8.3,P=0.000).There were significantly decrease in PGⅠ/Ⅱratio along with age increase.PGⅠ/Ⅱratio decreased signifi- cantly following with progression of gastric mucosa from normal (10.4) to non-atrophic lesions(8.8) and to atrophic lesions (6.6).Serum PGⅠand PGⅡin H. pylori positive subjects (88.7?g/L,11.4?g/L) were significantly higher than those in H.pylori negative subjects (81.4?g/L,8.4?g/L;P= 0.000),PGⅠ/Ⅱratio(7.7) was significantly lower in H.pylori positive subjects (9.6,P=0.000). For patients with atrophic lesions,the area under the PGⅠ/ⅡROC curve was 0.622.The best cut-off point for PGⅠ/Ⅱwas 6.9,with sensitivity of 53.2%,and specificity of 67.5%.Factors linked to PGⅠ/Ⅱwere identified using multinomial logistic regression:male (OR:1.151,95% CI:1.042—1.272, P=0.006),age=61(OR:1.358,95% CI:1.188—1.553,P=0.000),atrophic lesion(OR:2.075,95% CI:1.870—2.302,P=0.000),and H.pylori infection (OR:1.546,95% CI:1.368—1.748,P= 0.000).Conclusions The serum PG levels are significantly skewed from normal distrubition in the residents of Zhuanghe county,and affected by age and gender,as well as associated with gastric diseases and H.pylori in- fection.Compared with PGⅠand PGⅡalone,PGⅠ/Ⅱis more suitable for screening gastric cancer.