Biomedical subjects
Publications and source records attributed to H Rübben.
1122 cytological diagnoses have been made on 2500 Papanicolaou stained cytological slides from Patients with urothelial carcinomas. The cytological accuracy was 78% for G1 tumours, 94% for G2 and 96% for G3 carcinomas. A histologically diagnosed G1 carcinoma was cytologically G1 in 81% of cases, a G2 carcinoma was recognized in 64% and G3 carcinoma in 48%.
615 urothelial bladder tumors are evaluated retrospectively after reclassification of histological and cytological specimens according to the recommendations of the World Health Organization (1973) and International Union Against Cancer (1974). The reason for a subdivision of the T1 category for exophytic noninfiltrating carcinomas is discussed. The importance of stage and grade is demonstrated as well as the different prognosis of patients with primary or recurrent tumors of the same T category. The results of the study demand a differentiated therapeutic regimen for urothelial bladder tumors.
Computer tomography cannot only produce transversal sections of the body, but also evaluate the x-ray absorption values of various organs and tissues. It was first used in the investigation of the brain and has influenced the use of traditional neuroradiological techniques. Computer tomography can be used in special cases of diseases of the urogenital system. It is especially helpful in the diagnosis of primary or secondary retroperitoneal processes and also for tumors of the kidney. It allows effective frequent follow up of various therapies and has no side effects. Also in the follow up of various tumors, this noninvasive technique can demonstrate possible recurrences. It appears however that the total body computer tomography will not replace traditional radiological technique. During treatment and follow up of malignant tumors of the urogenital system however it appears very helpful.
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From the extensive statistics concerning treatment results of urological tumours which are available from central tumour registers, a first draft of a treatment plan has been worked out, which is based on tumour spread. Since the extent of tumour invasion is documented by the TNM system of the UICC, one is justified in speaking of TNM orientated treatment planning. For planning it is necessary to consider not only tumour type and depth of infiltration of local tissues, but also the lymph node anatomy, whether the nodes are involved or not. Computer tomography assist significantly in the performance of such TNM orientated treatment planning, particularly in determining the extent of the volume to be irradiated, It must be stressed that computer tomography does not replace the use of simulators, but that it is a valuable addition. In our view, computer tomography has also an undoubted value in treatment planning of urological tumours where palliation only is the aim. It provides the possibility of checking the effect of the chosen treatment by a non-invasive diagnostic method.
Three own observations of immunoblastic sarcomas with clinically primary manifestation in the testis are reported. In all cases an already generalized tumor stage was evident. In two patients a combined surgical, radiological, and chemotherapeutic treatment was performed with satisfactory success. The essential functional-morphological and clinical criteria of the immunoblastic sarcoma were summarized and discussed.
The prognostic influence of the nuclear DNA distribution pattern of human urothelial carcinomas of the bladder was investigated in 25 patients. Nuclear DNA content was measured by scanning microphotometry in Feulgen-stained histologic sections. A DNA malignancy grade (DNA-MG) ranging from 0.01 to 3 on a continuous scale was computed for each patient from the single cell DNA values. With the aid of the Cox proportional hazard regression model, DNA-MG was revealed as having a strong influence on survival time (p = 0.0004). Possible influences of other parameters (histological grade, stage, endoscopical tumor size and multiplicity, age) on survival could not be assessed in this model. This may be explained by the low number of cases and by the weakness of the influence of these parameters. Divided into two groups of patients according to their DNA-MG (group I: DNA-MG less than 1.5, group II: DNA-MG greater than or equal to 1.5), the histological grade had an influence on survival (p = 0.021). There was a good association of DNA-MG and histological grade (p = 0.05). In comparison to the histological grade DNA-MG seems to allow a more precise prognostic statement for the individual patient as it reveals additional information on survival for patients categorized according to their histological grade. We conclude that DNA-MG is an objective and scalar index for the prognosis of bladder carcinoma patients.