CAJ | 학술논문

目的：利用受试者工作特征曲线（receiver operator characteristic curve ROC曲线）探讨血清卵泡刺激素（FSH）的切点值，以预测非梗阻性无精子症患者睾丸的精子发生。方法选取104例非梗阻性无精子症患者测定其血清FSH（IU/L）值，行经皮睾丸取精子术（TESA）并根据睾丸活检报告分为有精子组（1组）和无精子组（2组）。结果 FSH≤7有52例（50%），找到精子51例，其概率为98.08%（51/52）；7＜FSH≤14有20例（19.23%），找到精子17例，其概率为85%（17/20）；14＜FSH≤21有13例（12.50%），找到精子3例，其概率为23.08%（3/13）；FSH＞21有19例（18.27%），找到精子6例，其概率为31.58%（6/19）。利用ROC曲线优选的血清FSH切点值是13.78IU/L，该点其敏感性为85.2%，特异性为88.3%，血清FSH水平的ROC曲线下面积为0.895，表明其诊断准确性较高。结论非梗阻性无精子症患者血清FSH水平对预测睾丸精子发生有重要意义。
목적：이용수시자공작특정곡선（receiver operator characteristic curve ROC곡선）탐토혈청란포자격소（FSH）적절점치，이예측비경조성무정자증환자고환적정자발생。방법선취104례비경조성무정자증환자측정기혈청FSH（IU/L）치，행경피고환취정자술（TESA）병근거고환활검보고분위유정자조（1조）화무정자조（2조）。결과 FSH≤7유52례（50%），조도정자51례，기개솔위98.08%（51/52）；7＜FSH≤14유20례（19.23%），조도정자17례，기개솔위85%（17/20）；14＜FSH≤21유13례（12.50%），조도정자3례，기개솔위23.08%（3/13）；FSH＞21유19례（18.27%），조도정자6례，기개솔위31.58%（6/19）。이용ROC곡선우선적혈청FSH절점치시13.78IU/L，해점기민감성위85.2%，특이성위88.3%，혈청FSH수평적ROC곡선하면적위0.895，표명기진단준학성교고。결론비경조성무정자증환자혈청FSH수평대예측고환정자발생유중요의의。
Objective To explore the cut-off value of the serum follicle-stimulating hormone (FSH) by using receiver operator characteristic curve(ROC curve) for prediction of spermatogenesis in the testis of the non-obstructive azoospermic patients. Methods Levels of serum FSH (IU/L) in 104 non-obstructive azoospermic patients were first measured. Based on the results of testicular sperm aspiration (TESA), the patients were divided into sperm group (No.1 group) and non-sperm group (No.2 group). Results In 52 (50%) of 104 patients, level of their serum FSH was lower than 7, and 51 patients(98.08%) of them were positive in sperm retrieval; in 20/104 (19.23%) patients, level of their serum FSH ranged from 7 to 14, and 17 patients(85%) were positive in sperm retrieval; In 13/104(12.50%)patients, level of their serum FSH range from 14 to 21, and 3 patients (23.08%)were positive in sperm retrieval; In 19/104(18.27%) patients, level of their serum FSH more than 21, and 6 patients (31.58%)were positive in sperm retrieval; The cut-off value is 13.78IU/L for FSH, with sensitivity of 85.2% and specificity of 88.3%, The area under curve(AUC) was 0.895, indicating a high diagnostic accuracy. Conclution Serum FSH level of non-obstructive azoospermic patients is very important in predicting spermatogenesis in the testis.