Author/Authors :
Abouhashem, Safwat E. Zagazig University - Departments of Urology, Egypt , Abouhashem, Safwat E. Taiba University - Department of Surgery, Saudi Arabia , Saba, Isam Zagazig University - Departments of Pathology, Egypt , Mostafa, Salah Zagazig University - Departments of Urology, Egypt , Abdalla, Alaa Zagazig University - Departments of Urology, Egypt , Almaramhy, Hamdi Taiba University - Department of Surgery, Saudi Arabia , Mostafa, Mohamed Zagazig University - Departments of Urology, Egypt , Elsayed, Deyab Zagazig University - Departments of Urology, Egypt , Ibrahim, Ehab Zagazig University - Departments of Urology, Egypt , Maroof, Aref Zagazig University - Departments of Urology, Egypt , Eladl, Mahmoud Zagazig University - Departments of Urology, Egypt
Abstract :
Objective: To assess the possibility of using cytological examination and DNA image-analysis of testicular fine-needle aspirates instead of open surgical biopsy in the investigation of infertile men, as testicular biopsy has long been used for investigating infertility but the interpretation of histological slides is usually sub- jective. Patients and methods: Thirty-three men (aged 22–36 years) were evaluated for infertility and underwent both open biopsy and fine-needle aspiration of their testes. Subsequently, the needle aspirates were assessed histopathologically and cytologi- cally, and by DNA image cytometry. The percentages of haploid, diploid and tetraploid cells were determined for each patient. Results: The cases were divided into four categories: (1) Complete spermatogen- esis, with a DNA pattern of 1n 2n 4n; (2) Maturation arrest, with a DNA pattern of 2n 4n with no haploid cells; (3) Sertoli cell-only syndrome, with a DNA pattern of only 2n, with no haploid or tetraploid cells; (4) Hypospermatogenesis, with a variable DNA pattern, i.e. mild with 1n 2n, moderate with 2n 1n 4n, and marked where the DNA pattern was 2n 4n 1n. From the cytological and DNA image-analysis of the aspirate a diagnosis was possible that had a strong correlation with the histological diagnosis of the same case. From image analysis we could exclude interstitial cells, Sertoli cells and sperms on the static image, and differentiate between spermatozoa and spermatids based on morphological characteristics in the cytological smear. This technique can therefore be used to quantitatively determine the percentages of various cell types within the seminiferous tubules. By coupling image ploidy analysis and cytological examination of a cytological smear, spermato- genesis can be assessed accurately. Conclusion: Image cytometry could be used to exclude interstitial cells, Sertoli cells and sperms on the static image and so produce an accurate assessment of sper- matogenesis. A combination of ploidy and cell morphology characteristics in cyto- logical smears provides an accurate, reproducible and easily used alternative to open testicular biopsy.
Keywords :
Cytological examination , DNA image analysis , Testicular fine , Needle aspirate
