Multimodal biomarker profiling in varicocele predicts surgical recovery.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Biomarkers in medicine Pub Date : 2026-07-01 Epub Date: 2026-08-04 DOI:10.1080/17520363.2026.2686307

Lei Zheng, Zhiming Wen, Letian Wei, Tao Jiang

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引用次数: 0

Abstract

Aims: Varicocele (VC) remains a leading correctable cause of male infertility, yet standardized multimodal biomarkers are lacking for clinical stratification and outcome prediction.

Patients and methods: This prospective observational study enrolled 131 primary VC patients and 20 healthy controls, evaluating semen parameters, sperm DNA fragmentation index (DFI), testicular shear wave elastography (SWE), hormonal profiles, and inflammatory/metabolic markers.

Results: VC patients showed reduced sperm progressive motility (sperm PM) (p < 0.001), elevated DFI (p = 0.002), increased abnormal sperm morphology (p < 0.001); smaller left (p = 0.002) and right (p = 0.029) testis, volume difference (p = 0.030); bilateral testicular stiffness (left p < 0.001, right p < 0.001); higher homocysteine (p = 0.001); and a lower T/E2 ratio (p = 0.030). DFI correlated negatively with sperm PM (r = -0.367, p < 0.001). Postoperative improvements were observed in sperm PM (p < 0.001), sperm morphology (p < 0.001), DFI (p < 0.001), left testicular elasticity (p < 0.001), right testicular elasticity (p < 0.001), homocysteine (p = 0.001), testosterone (p = 0.011), and the T/E2 ratio (p = 0.011). Preoperative DFI (OR =1.045), abnormal sperm morphology rate (OR =1.604), and sperm PM (OR =0.951) independently predicted complete semen parameter recovery at 3 months (AUC = 0.863, sensitivity 67.9%, specificity 89.5%).

Conclusion: An integrated multimodal framework incorporating imaging, molecular, and functional biomarkers facilitates prognostic stratification and personalized management of varicocele-associated infertility.

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精索静脉曲张的多模式生物标志物分析预测手术恢复。

目的：精索静脉曲张（VC）仍然是男性不育的主要原因，但缺乏标准化的多模式生物标志物用于临床分层和结果预测。患者和方法：这项前瞻性观察性研究纳入了131例原发性VC患者和20名健康对照者，评估了精液参数、精子DNA碎片指数（DFI）、睾丸剪切波弹性成像（SWE）、激素谱和炎症/代谢标志物。结果：VC患者精子进行性活动力（精子PM）降低（p p = 0.002），精子形态异常（p p = 0.002）和右侧睾丸（p = 0.029）增多，体积差异（p = 0.030）；双侧睾丸僵硬（左p p p = 0.001）；T/E2比值较低（p = 0.030）。DFI与精子PM （r = -0.367, p p p p p p p = 0.001）、睾酮（p = 0.011）、T/E2比值（p = 0.011）呈负相关。术前DFI （OR =1.045）、精子形态异常率（OR =1.604）、精子PM （OR =0.951）独立预测3个月精液参数完全恢复（AUC = 0.863，敏感性67.9%，特异性89.5%）。结论：结合影像学、分子和功能生物标志物的综合多模式框架有助于精索静脉曲张相关性不孕症的预后分层和个性化管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomarkers in medicine 医学-医学：研究与实验

CiteScore

3.80

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.