Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urothelial tumours of the upper urinary tract are rare, but their incidence increases in subjects suffering from phenacetin nephropathy, Balkan nephropathy and infected pyelic calculi. In order to act on the urothelium through the urinary way, a cancerigenic substance must (1) be eliminated with the urine; (2) be absorbed by the urothelium; (3) remain in the tissue for a certain length of time. Any situation leading to a prolongation of intra-tissue stasis favours the action of carcerigenic substances. The hypothesis is put forward that interstitial nephritis, by impeding the reabsorption from the pelvis by pyelo-lymphatic reflux and by making more difficult the lymphatic drainage of the pyelic and ureter walls, leads to a condition favouring carcinogensis, especially if the subject is exposed to contact with even not very active carcinogens. It is possible to foresee that in future the incidence of upper urinary tract tumours should increase in chronic uraemic patients under dialytic treatment and in transplant patients.
 ...
PMID:Chronic interstitial nephritis as a cause of tumours of the upper urinary tract. A hypothesis. 49 41

The aim of this investigation was to study the frequency of urinary tract tumors (UTT) in settlements around the South Morava River and its tributaries where Balkan nephropathy is endemic. For this purpose 659 surgery and autopsy records of patients with UTT were reviewed. The records came from 25 counties and 1279 settlements classified as endemic, hypoendemic and nonendemic. Upper tract urothelial, urinary bladder and kidney tumors were included in the evaluation. A highly significant geographic correlation between Balkan nephropathy and UTT localized in renal pelvis and ureter was noted in the South Morava River valley. These tumors were 57 and 61.8 times more frequent in endemic settlements than in control rural and city populations free of Balkan nephropathy. The frequency of urinary bladder tumors in endemic settlements was also increased compared with the nonendemic villages and large cities, up to 11.9 and 8.5 times, respectively. In endemic settlements, upper urinary tract tumors were five times and tumors of urinary bladder were seven times more frequent in families with Balkan nephropathy than in those without, and up to 224 times more frequent than in the city families. Familial clustering of UTT was also noted. The geographic correlation between Balkan nephropathy and UTT supports the speculation that these disorders share a common etiology.
 ...
PMID:Urinary tract tumors and Balkan nephropathy in the South Morava River basin. 176 41

Transitional cell carcinoma (TCC) of ureter and renal pelvis is relatively uncommon. Smoking, occupational carcinogens, analgesic abuse, Balkan nephropathy are the risk factors. Cytogenetic studies revealed that the most frequent aberration is the partial or complete loss of chromosome 9. Approximately 20-50% of patients with upper urinary tract (UUT) TCC have bladder cancer at some point on their course, whereas the incidence of UUT TCC after primary bladder cancer is 0.7-4%. Excretory urography and retrograde pyelography are the conventional diagnostic tools; however, ureteropyeloscopy combined with cytology and biopsy is more accurate. Grade and stage of the disease have the most significant impact on survival. Nephroureterectomy with bladder cuff excision has been the mainstay of treatment. Local resection may be appropriate for distal ureteral lesions especially when the disease is low grade and stage. Advances in endourology have made it possible to treat many tumors conservatively. Ureteroscopic and to a certain extent percutaneous surgical approaches are widely used today especially in patients with low grade, low stage disease. Endoscopic close surveillance is mandatory for these patients. Adjuvant topical therapies appear to be safe but confirmation of any benefits awaits the results of further large studies. More recently, laparoscopic techniques have become a viable alternative to open surgery, but long term cancer control data are lacking. Aggressive surgical resection does not affect the outcome of patients with advanced disease. Adjuvant radiotherapy is ineffective, and systemic chemotherapy results in a low complete response rate for patients with metastases.
 ...
PMID:Transitional cell carcinoma of the ureter and renal pelvis. 1290 9

Transitional-cell carcinoma of the renal pelvis or ureter is a relatively rare disease. Several risk factors are smoking, occupational carcinogens, analgesic abuse or Balkan nephropathy. The grade and stage of the disease have the most significant impact on the outcome. The treatment of renal pelvis and ureter tumours is open or laparoscopic surgery varying from conservative to more extensive surgical procedures, i.e. radical nephroureterectomy including removal of the contents of Gerota's fascia with ipsilateral ureter and a cuff of bladder at its distal extent. Most available data are from retrospective studies and surgery is the mainstay of treatment. Chemotherapy and/or radiation therapy are possible adjuvant or primary treatment for selected patients; however, prospective studies are needed to confirm their use.
 ...
PMID:Management of transitional-cell carcinoma of the renal pelvis and ureter. 1956 29

Primary cancers of the ureter and renal pelvis are rare tumours, > 90% of which are transitional cell carcinomas. Only approximately 5% of urothelial tumours arise in the upper urinary tract (UUT). Many environmental factors contribute to the development of these cancers. Some are similar to bladder cancer-associated factors (tobacco, occupational exposure), while others are more specific to carcinogenesis of the UUT (phenacetine, Balkan endemic nephropathy [BEN], Chinese herb nephropathy or association with Blackfoot disease [BFD]). This review discusses the environmental factors involved in UUT carcinoma. Tobacco and occupational exposure remain the principal exogenous risk factors for developing these tumours. Conversely, carcinogenesis of UUT tumours resulting from phenacetine consumption has almost disappeared. Although the incidence of BEN is also on the decline, roles for aristolochic acid and the consumption of Chinese herbs in the physiopathology and induction of this nephropathy, respectively, have proposed. In Taiwan, the association of this tumour type with BFD and arsenic exposure remains unclear to date. As some genetic polymorphisms are associated with an increased risk of cancer or faster disease progression, there is variability in interindividual susceptibility to the development of UUT carcinoma when exposed to the aforementioned risk factors Cytosolic sulfotransferases (SULTs) catalyse the detoxification of many environmental chemicals but also in the bioactivation of dietary and other mutagens. Polymorphism of the SULT gene, is thought to confer susceptibility to upper tract tumours.
 ...
PMID:Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. 1968 73

Upper Tract Urothelial Carcinoma (UTUC) is an uncommon disease which occurs more frequently in some regions of Balkan countries than in other areas in the world. Investigation of UTUC in the South Morava River basin and its tributaries where BEN is endemic revealed increased frequency not only of tumour of the renal pelvis and ureter but also of urinary bladder tumours. A comparative morphological and immunohistochemical study of UTUC in the BEN region and control rural and city populations free of BEN, identify growth pattern as the best morphological characteristic which differentiated BEN and control tumours, i.e. solid growth for BEN tumours and papillary for control tumours. Overexpression of tumour suppressor p53 as well as decreased expression of E-CD was detected in BEN tumours. Other cells cycle related molecular markers--Cyclin D1, p16, and HER-2 showed no difference in expression between groups, as well as the proliferative marker Ki-67. Investigation of apoptosis-related markers identifies Bax as a specific marker of BEN-associated UTUC. Decrease of the pro-apoptotic protein Bax together with alteration of Survivin may be indicative of specific disturbances of an intrinsic apoptotic pathway in UTUC arising in endemic areas.
 ...
PMID:Endemic nephropathy and upper urothelial carcinoma--new insights in molecular biology. 2480 10

The purpose of the current review was to describe the clinical risk for Lynch syndrome (LS) after exposure to aristolochic acid (AA) in cases of upper urinary-tract urothelial carcinoma (UTUC). A systematic review of the scientific literature was performed using the Medline database (National Library of Medicine, PubMed) using the following keywords: epidemiology, risk factor, AA, Balkan nephropathy (BNe), LS, hereditary cancer, hereditary non-polyposis colorectal cancer (HNPCC), mismatch repair genes, urothelial carcinomas, upper urinary tract, renal pelvis, ureter, Amsterdam criteria, genetic counselling, mismatch repair genes, genetic instability, microsatellite, and Bethesda guidelines. LS is a specific risk for UTUC, which is the third most frequent cancer (in its tumor spectrum) after colon and uterine lesions. Mutation of the MSH2 gene is the most commonly described cause of UTUC in LS. Diagnosis is based on clinical suspicion and is guided by Bethesda and Amsterdam criteria. It is secondarily confirmed by immunohistochemical analyses of the tumor and a search for gene mutations. The presence of LS in patients with UTUC is a favorable prognosis factor for survival during follow-ups. AA is a specific environmental risk factor for UTUC and tubulo-interstitial nephropathy. It has been involved in the development of nephropathies in link with the Balkan disease and intake of Chinese herbal medicine. More broadly, the use of traditional plant medicines from the genus Aristolochia has created worldwide public-health concerns. UTUCs share common risk factors with other urothelial carcinomas such as tobacco or occupational exposure. However, these tumors have also specific risk factors such as AA exposure and LS that clinicians should be aware of because of their clinical implication in further management and follow-up.
 ...
PMID:Lynch syndrome and exposure to aristolochic acid in upper-tract urothelial carcinoma: its clinical impact? 2778 21