Dr.med. Hussain Al-Abadi
Facharzt für Urologie
(Saugbiopsie, DNA-Zytometrie)

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Priv.Dozent Dr. med. Hussain Al-Abadi
Facharzt für Urologie, Prostata-Diagnostik
Saugbiopsie (Feinnadel-Aspirationsbiopsie, FNAB) und DNA-Zytometrie

Prostate. 1983;4(6):553-68.

Treatment of prostatic cancer with LH-RH analogues.

Borgmann V, Nagel R, Al-Abadi H, Schmidt-Gollwitzer M.

Twenty-one of 32 patients with locally advanced prostatic cancer (stage C) were treated with the LH-RH analogue Buserelin for 7-19 months. After an initial sequence of subcutaneous injections, treatment was continued with intranasal spray application (three daily doses of 400 micrograms each) which ensured maintenance of serum testosterone within the range seen in castrated men. To evaluate the response of the primary tumor to Buserelin, cytological regression was established for all patients by fine-needle aspiration biopsy every 3 months. The cytological results corresponded with those of DNA analyses of single-cell cytophotometry showing a statistically significant drop of the grade of aneuploidy or polyploidy when the prostatic carcinoma responded positively to Buserelin therapy. Seventeen of 21 patients treated with the potent LH-RH analogue showed good therapy response. Four patients with no cytological signs of tumor regression received secondary treatment with estramustine phosphate because of hormone resistence. One patient had to be crossed over to cyclophosphamide, the third drug, for clinical progression after 15 months. Essential side effects have not been observed. Continuous treatment of locally advanced prostatic cancer with Buserelin, combined with close control of the patient, offers not only a real alternative to surgical castration--as the patient is spared the psychical stress of orchiectomy--but also to estrogen therapy with its risk of cardiovascular side effects.

PMID: 6415628 [PubMed - indexed for MEDLINE]

Am J Clin Oncol. 1988;11 Suppl 1:S19-28.

Treatment of locally advanced prostatic carcinoma with LHRH analogues: cytological, DNA-cytophotometrical, and clinical results.

Borgmann V, al-Abadi H, Nagel R.

Department of Urology, Charlottenburg Medical Center, Free University of Berlin, West Germany.

From June 1, 1981 to December 31, 1985, 122 patients aged 54 to 83 years, with locally advanced prostatic carcinoma, were treated with buserelin. Nineteen of the patients received combined therapy with buserelin and androcur for the first 3 months. To control the response of the primary tumor to therapy, fine-needle aspiration biopsy of the prostate was made in all patients at 3-month intervals. Fifty-eight (76.3%) of 76 patients with locally advanced prostatic carcinoma, with or without bone metastases, who underwent buserelin therapy for periods of 12-54 months showed good to satisfactory regression grades in the primary tumor. Eighteen patients (23.7%) showed poor regression or none, established by cytological findings and the measure of DNA by means of single cell-scanning cytophotometry. In three of the 58 patients, tumor progression or bone metastases occurred despite favorable regression grade; these were the only cases in which there was a discrepancy between the clinical course of the disease and the grade of regression in the primary tumor. According to TNM classification, 68 of the 78 patients treated for 12-54 months were in stage T3 NX M0; eight were in stage T3/T4 NX M1. On the basis of our long-term studies, it can be stated that buserelin therapy induces positive therapy response in more than 75% of locally advanced, inoperable, primary prostatic carcinoma. The clinical castration caused by buserelin through selective suppression of gonadotrophic secretion in the pituitary gland is, as the term implies, no more effective than surgical castration. However, the gonadotrophin suppression induced by buserelin is reversible and spares the patient the psychic stress of orchiectomy. This is a decisive advantage in light of the fact that in 20-40% of patients with locally advanced primary prostatic carcinoma, the primary tumor is hormone-refractory, and surgical castration would prove unnecessary after all.


PMID: 2968759 [PubMed - indexed for MEDLINE]

Scand J Urol Nephrol Suppl. 1991;138:83-92.

The prognostic significance of ploidy and DNA-heterogeneity in the primary diagnosis and monitoring of patients with locally advanced prostatic carcinoma.

Nagel R, al Abadi H.

Department of Urology, Charlottenburg Medical Center, Free University of Berlin, F.R.G.

Single-cell DNA cytophotometry was employed to analyze the tumors of 271 patients with locally advanced prostatic carcinoma as to DNA ploidy and heterogeneity and the distribution of the phases of the cell cycle before and during therapy, with the intention of establishing prognostic factors apart from those already known (stage, grade). Follow-up periods ranged from 1 to 9 years. One hundred and ninety-eight (73%) of the 271 patients had carcinoma stage T3 NO MO, and 73 (27%) of them had carcinoma state T3/T4 N+ M1. The tumors were evaluated cytologically to establish the grades of malignancy. 11.8% were grade-1 carcinoma, 64.3% were grade-II and 23.8% were grade-III carcinoma. Single-cell DNA cytophotometry demonstrated aneuploidy rates of up to 73% and diploidy rates of up to 23.8% for the higher grades of malignancy, whereas the diploidy rate established for grade I carcinoma was 71% and the respective aneuploidy rate was 15.2%. These differences are significant (p less than 0.001). There was a significant correlation between the results of DNA cytometry and the clinical course of the disease. Patients with diploid tumor-cell nuclei developed no metastases and no local tumor progression during the follow-up of 9 years, whereas patients with aneuploid tumor-cell nuclei showed metastases and local tumor progression within 8-22 months, despite changes in therapy. These patients died of carcinoma after an average 18 months following primary diagnosis.

PMID: 1785025 [PubMed - indexed for MEDLINE]

J Urol. 1992 Jul;148(1):31-7.

Transitional cell carcinoma of the renal pelvis and ureter: prognostic relevance of nuclear deoxyribonucleic acid ploidy studied by slide cytometry: an 8-year survival time study.

al-Abadi H, Nagel R.

Department of Urology, Free University of Berlin, Federal Republic of Germany.

In 72 patients with urothelial carcinoma of the renal pelvis or ureter the ploidy, deoxyribonucleic acid (DNA) heterogeneity and counts of cell cycle phases in the tumor were analyzed by means of single cell DNA cytophotometry with the intention of finding new prognostic factors in addition to those already known (stage and grade). Followup ranged from 1 to 8 years. The results of the DNA analyses were related to the tumor categories, histopathological grading of the tumors and clinical course. Malignancy grade 1 tumors showed DNA frequency peaks in the diploid range, while tumors assessed as malignancy grade 2 showed heterogeneous DNA distribution patterns. Malignancy grade 3 tumors exhibited 71% aneuploid and 29% tetraploid DNA values. The proliferation rate of the tumor cells was statistically significantly higher in malignancy grades 2 and 3 than in malignancy grade 1. The prognosis for grade 1 tumors is good, whereas it is unfavorable in the case of grade 3 tumors. For these 2 groups (patients with grades 1 and 3 tumors) DNA ploidy affords no additional prognostic information. Grade 2 tumors, on the other hand, are heterogeneous in respect to DNA ploidy although they exhibit the same histomorphological degree of differentiation. These tumors can be subclassified as aneuploid (biologically aggressive) and diploid or tetraploid (biologically less aggressive) tumors. There was also a positive correlation between T category and DNA ploidy. The cell lines were aneuploid in 38% of the patients with stage T1 tumors, 56% with stage T2 tumors and almost 85% with stage T3, N+ tumors. A significant correlation was found between the results of DNA cytophotometry and the clinical course of the disease. Patients with diploid tumor cell nuclei had no metastases and no local tumor progression for up to 8 years, whereas patients with aneuploid tumor cell nuclei suffered metastasis and local tumor progression within 24 to 36 months. The patients died of the tumor 36 months after primary diagnosis on the average. The determination of DNA ploidy, tumor heterogeneity and tumor cell proliferation by means of DNA cytophotometry affords valuable clues as to prognosis.

PMID: 1613875 [PubMed - indexed for MEDLINE]

Eur Urol. 1992;22(4):303-10.

Nuclear DNA analysis: DNA heterogeneity in the monitoring of patients with locally advanced prostatic carcinoma.

al-Abadi H, Nagel R

Department of Urology, Clinical Cytology and DNA Cytometry, Charlottenburg Medical Center, Free University of Berlin, FRG.

Single-cell DNA cytophotometry was employed to analyze the tumors of 271 patients with locally advanced prostatic carcinoma as to DNA ploidy and heterogeneity and the distribution of the phases of the cell cycle before and during therapy, with the intention of establishing prognostic factors apart from those already known (stage, grade). Follow-up periods ranged from 1 to 9 years. 198 (73%) of the 271 patients had carcinoma stage T3 N0 M0, and 73 (27%) of them had carcinoma stage T3/T4 N+M1. The tumors were evaluated cytologically to establish the grades of malignancy. 11.8% were grade I carcinoma, 64.3% were grade II and 23.9% were grade III carcinoma. Single-cell DNA cytophotometry demonstrated aneuploidy rates of up to 73% and diploidy rates of up to 23.8% for the higher grades of malignancy, whereas the diploidy rate established for grade I carcinoma was 71% and the respective aneuploidy rate was 15.2%. These differences are significant (p < 0.001). There was a significant correlation between the results of DNA cytophotometry and the clinical course of the disease. Patients with diploid tumor cell nuclei developed no metastases and no local tumor progression during the follow-up period of 9 years, whereas patients with aneuploid tumor cell nuclei showed metastases and local tumor progression within 8-22 months, despite changes in therapy. These patients died of carcinoma after an average 18 months following primary diagnosis.

PMID: 1490508 [PubMed - indexed for MEDLINE]

The Cell Cycle: Regulators, Targets, and Clinical Applications, VW Hu (ed.), Plenum Press, New York, 1994.

Clinical Relevance of DNA Ploidy And Cell Cycle Phases in Transitional Cell Cacinoma of the Renal Pelvis and Ureter: A Study by Means of Static DNA-Cytophotometry.

al-Abadi H, Nagel R.

Department of Urology, Clinical Cytology and DNA Cytophotometry, Rudolf Virchow Medical Center, Free University of Berlin, Germany

In 72 Patients with urothelial carcinoma of the renal pelvis or ureter the ploidy and counts of cell cycles phases in the tumor were analyzed by means of single cell DNA cytophotometry with the intention of finding new prognostic factors in addition to those already known (stage and grade). Follow-up ranged from 1 to 10 years. The results of the DNA analyses were related to the tumor categories, histopathological grading and clinical course. Malignancy grade 1 tumors showed DNA frequency peaks in the diploid range, while tumors assessed as malignancy grade 2 showed heterogeneous DNA distribution patterns. Malignancy grade 3 tumors exhibited 71% aneuploid and 29% tetraploid DNA values.
DNA histograms also show the distribution of the cell cycles phases in a cell population measured. The individual tumor cell nuclei are assigned to the different phases of the cell cycle (G0/G1, S phase and G2/M phases) according to the DNA content. Our results show that the prognosis for patients with more than 50% diploid cells in G0/G1 phase is better than for those with a lower percentage of cells. As a rule, a high percentage of G0/G1 cells is a sign of a slow growth rate of the tumor. The differences in survival times associated with the rates of G0/G1 cells and S and G2/M cells are not only evident in the patients with malignancy grade 1 but also in those with malignancy grades 2 and 3.
There was also a positive correlation between pT categpry and DNA ploidy. The cell lines were aneuploid in 38% of the patients with stage pT1 tumors, 56% with stage pT2 tumors and almost 85% with stage pT3, N+ tumors. A significant correlation was found between the results of DNA cytophotometry and the clinical course of the disease. Patients with diploid tumor cell nuclei had no metastases and no local tumor progression for up to 10 years, whereas patients with aneuploid tumor cell nuclei suffered metastasis and local tumor progression within 24 to 36 months. The patients died of the tumor 36 months after primary diagnosis on the average.
The determination of tumor ploidy and tumor cell cycle phases in urotheial carcinoma of the renal pelvis and ureter by means of DNA cytophotmetry yields valuable prognostic information.

Verh. Dtsch. Ges. Zyt. 1995, 19:181-197

Klinische Bedeutung der Zytologie und DNS-Zytometrie in der Therapie des Prostatakarzinoms
Clinical relevance of cytology and DNA-cytometry in the therapy of patients with prostatic carcinoma

Al-Abadi H, Nagel R

Urologische Klinik und Poliklinik, Klinikum Rudolf Virchow, Freie Universitäat Berlin

Single-cell DNA cytophotometry was employed to analze the tumors of 271 patients with locally advanced prostatic carcinoma as to DNA ploidy and heterogeneity and the distribution of the phases of the cell cycle before and during therapy, with the intention of establishing prognostic factors apart from those already known (stage, grade). Follow-up periods ranged from 1 to 12 years.
198 (73%) of the 271 patients had carcinoma stage T3 N0 M0, and 73 (27%) of them had carcinoma stage T3/T4 N+ M1. The tumors were evaluated cytologically to establish the grades of malignancy. 11.8% were grade-1-carcinomas, 64.3% were grade-2 and 23.8% were grade-3 carcinomas. Single-cell DNA cytophotometry demonstrated aneuploidy rates of up to 73% and diploidy rates of up to 23.8% for the higher grades of malignancy, whereas the diploidy rate established for grade-1-carcinoma was 71% and the respective aneuploidy rate was 15.2%. These differences are significant (p < 0.001).
There was a significant correlation between the results of DNA cytophotometry and the clinical course of the disease. Patients with diploid tumor-cell nuclei developed no metastases aand no local tumor progression during the follow-up period of 12 years, whereas patients with aneuploid tumor-cell nuclei showed metastases and local progression within 8 - 22 months, despite changes in therapy. These patients died of carcinoma after an average of 21 months following primary diagnosis.
* Meinem verehrten Lehrer Herrn Professor Dr. med H.-A. Müller gewidmet.


notabene medici 3:74-79(1995)

Zytomorphologie und DNS-Zytophotometrie beim Prostatakarzinom und ihre prognostische Bedeutung

al-Abadi H, Nagel R

Urologische Klinik und Poliklinik, Klinikum Rudolf Virchow, Freie Universität Berlin, Direktor: Prof. Dr. R. Nagel

Bei 271 Patienten mit lokal fortgeschrittenem Prostatakarzinom wurden mittels der Einzelzell-DNA-Zytophotometrie die Ploidie, die DNS-Heterogenität and die Anteile der Zellzyklusphasen der Tumoren vor und während der Therapie untersucht, um neben den bisherigen prognostischen Faktoren (Stadium, Grad) weitere prognostische Parameter zu finden. Der Zeitraum der Verlaufsbeobachtung betrug 1 bis 12 Jahre.
Von den 271 Patienten haben 198 Patienten (73.7%) einen T3 N0 M0-Tumor, während bei 73 Patienten (26.3%) ein Stadium T3/T4 N+ M1 vorlag. 11.8% der Patienten wiesen den zytologischen Malignitätsgrad 1, 64.3% der Patienten den Malignitätsgrad 2 auf, und 23.8% der Patienten hatten ein Grad-3-Karzinom. Die Einzelzell-DNS-Zytophotometrie ergab bei den höheren Malignitätsgraden 2 und 3 eine Aneuploidie-Rate bis zu 71% und eine Diploidie-Rate bis zu 23.8%. Bei dem Malignitätsgrad 1 dagegen lag die Aneuploidie-Rate bei 15.2%. Diese Unterschiede sind signifikant (p < 0.001).
Zwischen den Ergebnissen der DNS-Zytophotometrie und dem klinischen Verlauf bestand eine signifikante Korrelation. Patienten mit diploiden Tumorzellkernen entwickelten innerhalb einer Beobachtungszeit von 12 Jahren keine Metastasierung und keine lokale Tumorprogression, während Patienten mit aneuploiden Tumorzellkernen eine Metastasierung und eine lokale Tumorprogression trotz Therapieumstellung innerhalb von 8 bis 22 Monaten aufwiesen. Die Patienten in der aneuploiden Gruppe starben durchschnittlich 21 Monate nach dem Zeitpunkt der Primärdiagnose an ihrem Tumorleiden.


Acta Cytol. 1997 Jul-Aug;41(4):981-6.

Fine needle aspiration biopsy vs. ultrasound-guided transrectal random core biopsy of the prostate. Comparative investigations in 246 cases.

al-Abadi H

Department of Urology, Virchow Medical Center, Humboldt University, Berlin, Germany.

OBJECTIVE: To compare fine needle aspiration biopsy (FNAB) and ultrasound-guided transrectal core biopsy of the prostate. STUDY DESIGN: FNAB and the random core biopsy were performed simultaneously on 246 patients who either had striking palpable signs or increased levels of prostate-specific antigen, at least 5 micrograms/mL, on two separate examinations over a six-week period, RESULTS: The histologic and cytologic evaluations showed very close conformity between the two methods. Fifty-eight percent of the patients had benign prostate hyperplasia. Of the total number of patients, 103 (42%) had prostate carcinoma. This figure was confirmed in 101 (98%) of cases using FNAB. In two cases (0.8%) atypical prostate hyperplasia was diagnosed. In five cases the examination had to be repeated since insufficient prostate cell material was collected. Ultrasound-guided random core biopsy showed the presence of carcinoma in 96 of 103 patients (93%). It was necessary to repeat the examination in one patient due to a lack of adequate cell material. CONCLUSION: In our hands, FNAB method has a sensitivity of 98%, whereas core biopsy attained 91%. Both methods showed 100% concurrence in specificity.

PMID: 9250288 [PubMed - indexed for MEDLINE]


Publications by H. Al-Abadi
cited in BioInfoBank Library of the BioInfoBank Institute


Einführende Literatur - vorläufig angefügt von J. Gruber

  • A. Böcking, Mit Zellen statt Skalpellen: Wie sich Krebs früh und ohne Operation erkennen läßt, Schriftenreihe zur Gesundheitsanalyse, Band 48, Gmündner Ersatzkasse (GEK), 2006

  • W. Samsel (Zentrum für Sozialpolitik, Universität Bremen), A. Böcking (Institut für Cytopathologie der Universität Düssseldorf), Prognostische und therapeutische Bedeutung der DNA-Zytometrie beim Prostatakarzinom, Wissenschaftlicher Bericht über das Experten-Symposium an der Universität Bremen, 12.5.05, Schriftenreihe zur Gesundheitsanalyse, Band 41, Gmündner Ersatzkasse (GEK), Schwäbisch Gmünd, Januar 2006

    Inhalt

    1. D. Hebel: Geleitwort ... Seite 4
    2. W. Samsel, A. Böcking: Vorwort ... Seite 5
    3. W. Samsel: Zur Vorgeschichte dieses Symposiums ... Seite 9
    4. P. Duesberg: Ist Krebs eine genetische oder eine chromosomale Krankheit? ... Seite 13
    5. A. Böcking: DNA-Bildzytometrie - Methode zur Früherkennung und Malignitäts-Gradierung bösartiger Tumoren ... Seite 46
    6. H. Al-Abadi: Zytomorphologie und DNA-Zytometrie beim Prostata-Carcinom und ihre prognostische Bedeutung. Eine klinische prospektive Studie bei 271 Patienten mit Prostatakarzinom. Zytomorphologie und DNA-Zytophotometrie beim Prostatakarzinom und ihre prognostische Bedeutung ... Seite 98
    7. B. Tribukait: klinische Bedeutung der DNA-DurchflussZytometrie beim Prostatakarzinom ... Seite 115
    8. H. Bonkhoff: Prognosefaktoren des Prostata-Carcinoms ... Seite 134
    9. B. Aeikens: das Prostatakarzinom, eine Herausforderung für den niedergelassenen Urologen? ... Seite 151
    10. K.H. Bichler: Bedeutung der DNA-Bildzytometrie für die Therapieplanung beim Prostatakarzinom ... Seite 163
    11. A. Böcking: DNA-Grading der Malignität von Prostatakarzinomen in der Weltliteratur ... Seite 184
    12. Zusammenfassung der Diskussionen im Verlauf des Symposiums ... Seite 204
    13. Konsensus Statements der Teilnehmer des Symposiums zum DNA-Malignitätsgrading des Prostatakarzinoms am 12.05.2005 ... Seite 207
    14. Autorenverzeichnis ... Seite 209

  • A. Böcking, W. Samsel "Prostatakrebs: Diagnose und Prognose", GEK-Gesundheitsservice, Gmündner Ersatzkasse, GEK, Schwäbisch Gmünd, 2005
    • Welche Bedeutung hat die Feinnadelaspirationsbiopsie (FNAB)? Seite 10.
    • Was bringt die Feinnadel-Aspirationsbiopsie? Seite 10.
    • Wie funktioniert die Gewebeentnahme per FNAB? Seite 11.
      Durch eine in die Prostata eingeführte, haarfeine Nadel werden Zellen abgesogen. Dazu wird eine sehr feine (0,7 mm), lange Nadel in einer Führungshülse aus Metall vom Zeigefinger des Urologen geführt durch den Enddarm gezielt in die Prostata oder einen dort zu tastenden Knoten gebracht. Die Punktion kann auch gezielt unter Ultraschallkontrolle erfolgen.
      Fachliche Hintergrundinformationen:
      Die Feinnadelaspirationsbiopsie ist eine seit vielen Jahren bewährte, harmlose Methode zur Gewinnung von Zellmaterial zu diagnostischen Zwecken. Für die Prostata entwickelte der schwe- dische Urologe Justus Franzen dafür im Jahre 1960 ein spezielles Punktionsbesteck. Die FNAB ist in der Regel nicht schmerzhaft und nahezu komplikationsfrei (Leistenschneider W, Nagel R: Komplikationen bei transrektaler Stanz- und Feinnadelaspirationsbiopsie. Therapiewoche 28, 1963). Die Nadel ist mit einer normalen Spritze verbunden. Durch Zug am Spritzenstempel wird ein Unter- druck erzeugt. Die Nadel wird unter stetigem Sog in der Prostata hin und her geführt. So können mehrere tausend Zellen aus verschiedenen Regionen der Prostata entnommen werden. Durch fächer- förmiges Arbeiten kann man Zellproben aus nahezu allen Bereichen der Prostata gewinnen (und nicht nur aus wenigen Bezirken, wie bei der Stanzbiopsie). Die aspirierten Zellen werden anschließend auf einen Glas-Objektträger ausgeblasen, dünn ausgestrichen, mit alkoholischem Spray fixiert und gefärbt. So können im Normalfall gut 100 000 Zellen der Prostata gewonnen und zytologisch (nicht histologisch) vom Pathologen begutachtet werden. (siehe auch auf dieser Seite: DNA-Ploidie, DNA-Ploidy oder in National Library of Medicine: "DNA Ploidy, Prostate"
    • Histologische Methode zur Aggressivitätsbestimmung (Gleason-Score) Seiten 13 - 14
    • Zytologische Methode zur Aggressivitätsbestimmung (DNA-Zytologie) Seiten 16 - 30
      • Die DNA-Zytometrie zur Aggressivitätsbestimmung bei Prostatakrebs.
      • Warum ist die DNA-Bildzytometrie trotz ihrer Vorteile so wenig verbreitet?
      • Was muß man als Patient tun, damit beim Prostatakarzinom eine DNA-Bildzytometrie durchgeführt wird?
    • Literaturhinweise der Einführung

  • A. Böcking, Praxis der klinischen Zytodiagnostik

  • Sanfte Krebsdiagnostik, Institut für Cytopathologie des Universitätsklinikums Düsseldorf
    • Was ist Cytopathologie?
    • Wann hilft Cytopathologie?
    • Wie kann ich Cytopathologie nutzen?
    • Wie funktioniert Cytopathologie?
    • Wie sicher ist die Cytopathologie?
    • Was kostet Cytopathologie?
    • Was sind die Vorteile der Cytopathologie?

  • Diagnostik - DNA-Zytometrie, Prostatakrebs-Forum von KISP und BPS

Version:: 19. Dezember 2012
Hussain Al-Abadi
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