非阻塞性无精子症男性纯Sertoli细胞综合征睾丸的形态学变化

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论证。对不育男性睾丸活检标本进行形态学研究的意义在于该领域的信息和研究较少，这是因为它与在给定疾病学中获得终身活检的适应症有限。对纯 Sertoli 细胞综合征（Sertoli-cell-only syndrome, SCOS）中 Sertoli 细胞本身和睾丸间质的病理变化程度的研究仍然最少。

本研究的目的是评估纯Sertoli细胞综合征期间睾丸的形态变化。

材料和方法。通过对切片进行血红素和伊红染色、甲苯胺蓝染色以及光学显微镜检查，对 9 名非梗阻性无精子症纯Sertoli细胞综合征男性的曲细精管进行了研究。同时，统计了Sertoli细胞的数量、Sertoli细胞的萎缩性变化、曲细精管的厚度以及睾丸间质中肥大细胞的数量。此外，还对各变量之间的关系进行了相关分析。

结果。在48.2%的曲细精管中发现了成熟的Sertoli细胞，在33.6%的曲细精管中发现了有萎缩迹象的Sertoli细胞，在18.2%的精管中发现了有凋亡迹象的Sertoli细胞。单个精小管中的 Sertoli 细胞平均数量为 15.4 个（最小值为 8.1 个，最大值为 19.2 个）。曲细精管的直径平均为 33.8 微米（最小值为 23.0 微米，最大值为 42.1 微米）。它们在 纯Sertoli细胞综合征时的鞘膜厚度平均为 0.63（最小值为0.58；最大值为 0.69）微米。 睾丸间质中肥大细胞的数量平均为 8.5±0.3 个/1 平方毫米。曲细精管鞘膜的厚度与 Sertoli 细胞的数量呈反相关（r=-0.87），曲细精管鞘膜的厚度与睾丸间质中肥大细胞的数量呈强正相关（r=0.83）。

结论。在研究的病例中，纯Sertoli细胞综合征在非梗阻性无精子症患者中相当常见。曲细精管壁厚度的增加会破坏血睾屏障的结构。这项研究表明，肥大细胞对曲细精管管壁厚度有直接影响，这表明这些细胞可能对血脑屏障的通透性和精子发生障碍产生病理影响。

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作者简介

Nina G. Kulchenko

Peoples' Friendship University of Russia named after Patrice Lumumba

编辑信件的主要联系方式.
Email: kle-kni@mail.ru
ORCID iD: 0000-0002-4468-3670
SPIN 代码: 1899-7871

Cand. Sci. (Medicine)

俄罗斯联邦, Moscow

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2. Fig. 1. Distribution of convoluted seminiferous tubules depending on qualitative changes in Sertoli cells in patients with secretory azoospermia.

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3. Fig. 2. Histological specimen of a testicle from a patient with non-obstructive azoospermia and Sertoli cell-only syndrome; hematoxylin and eosin staining, ×400. Sertoli cells are adjacent with their base to the basement membrane of the convoluted seminiferous tubule (black arrows), and their apex reaches the lumen of the tubule (green arrows).

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4. Fig. 3. Average number of Sertoli cells in one convoluted seminiferous tubule depending on qualitative changes in it.

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5. Fig. 4. The number of mast cells depending on degenerative changes in Sertoli cells.

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6. Fig. 5. Histological specimen of testicle in non-obstructive azoospermia, “Sertoli cells only” syndrome. Toluidine blue staining: a — convoluted seminiferous tubule with mature Sertoli cells (×400 magnification); b — convoluted seminiferous tubule with signs of Sertoli cell dystrophy (×200 magnification), c — convoluted seminiferous tubule with signs of Sertoli cell apoptosis (×400 magnification). Black arrow point to mast cell located in testicular interstitium; green arrow point to mast cell located peritubularly; red arrow point to Sertoli cells; yellow arrow point to mast cell in the stage of active secretion; asterisks point to lumen of convoluted seminiferous tubule.

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