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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/11 21:41:10」(JST)

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The urothelium or uroepithelium (or "transitional epithelium")is the epithelium that lines much of the urinary tract. It is a layer of tissue that lines the renal pelvis, the ureters, the bladder, and parts of the urethra.^[1]

Structure and function

Urothelial tissue is highly specific to the urinary tract, and has high elasticity and trans-epithelial electrical resistance.^[1]

Urothelium consists of approximately 3-5 cell layers, accompanied by a thick layer of protective glycoprotein plaques at its luminal (apical) surface, and is classified as transitional epithelium.^{[citation needed]}

Pathology

Epithelia are sites of specific diseases.^{[citation needed]}

Cancers that originate in epithelial cells are termed carcinomas, and they are characterized as having lost the mature, differentiated morphology and molecular patterns of the normal tissue. Infectious diseases also afflict epithelia where diverse microbes (viruses, bacteria, fungi) have surface structures that bind specific features of particular epithelial cells (e.g., influenza virus binds respiratory epithelium). Genetic defects can also inhibit normal epithelial integrity, such as defects in intercellular adhesion molecules that result in blistering diseases.^{[citation needed]}

The second most common infectious disease is urinary tract infection (UTI). UTIs afflict approximately half of all women during their lifetime, and about 25% of these women will suffer recurrent UTIs. The majority of these infections are due to uropathogenic Escherichia coli bacteria (commonly known as E. coli). However, UTIs can also develop in healthcare settings and such infections are caused by a greater frequency of non-E. coli bacteria.^{[citation needed]}

One unusual condition which affects the urothelium is interstitial cystitis (IC), a condition with symptoms similar to UTI (urinary frequency, urinary urgency, pressure and/or pain). Urine culture, however, is negative. During hydrodistention of the bladder, small petechial hemorrhages (aka glomerulations) are frequently found throughout the bladder. Larger "Hunner's Ulcers", known for their characteristic waterfall bleeding effect, represent larger areas of bladder wall thinning and/or trauma. The cause of IC is currently unknown though some suggest that it could be genetic, the result of traumatic injury (aka chemical exposure), infection, autoimmune disease, etc. Researcher Susan Keay (University of Maryland) has found an unusual protein in the urine of IC patients which appears to interfere with healing, known as an Antiproliferative Factor. Research efforts into IC are focused on the urothelium, including newly discovered signaling molecules which suggest that the urothelium is far more than a barrier, as well as how the urothelium interacts with proximal nerves and smooth muscle.^{[citation needed]}

Urothelium is susceptible to carcinoma. Because the bladder is in contact with urine for extended periods, chemicals that become concentrated in the urine can cause Bladder cancer. For example, cigarette smoking leads to the concentration of carcinogens in the urine and is a leading cause of bladder cancer. Occupational exposure to certain chemicals is also a risk factor for bladder cancer.^{[citation needed]}

Urothelial lesions

Papillary urothelial lesions
- Papillary urothelial hyperplasia
- Urothelial papilloma
- Papillary urothelial neoplasm of low malignant potential (PUNLMP)
- Low-grade papillary urothelial carcinoma
- High-grade papillary urothelial carcinoma
- Invasive urothelial carcinoma

Flat urothelial lesions
- Reactive urothelial atypia
- Urothelial inverted papilloma
- Urothelial atypia of unknown significance
- Urothelial dysplasia
- Urothelial carcinoma in situ

Invasive urothelial carcinoma
- Invasive urothelial carcinoma (NOS)
- Urothelial carcinoma with inverted growth pattern
- Urothelial carcinoma with squamous differentiation
- Urothelial carcinoma with villoglandular differentiation
- Urothelial carcinoma, micropapillary variant
- Urothelial carcinoma, lymphoepithelioma-like variant
- Urothelial carcinoma, clear cell (glycogen-rich) variant
- Urothelial carcinoma, lipoid cell variant
- Urothelial carcinoma with syncitiotrophoblastic giant cells
- Urothelial carcinoma with rhabdoid differentiation
- Urothelial carcinoma similar to giant cell tumor of bone

References

Notes

^ ^a ^b Andersson, 2011: p. 134

Bibliography

Andersson, Karl-Erik (2011). Urinary Tract. Springer. ISBN 978-3-642-16498-9.

External links

www.urothelium.com is an online resource for information about Human Urothelium and the "Biomimetic Urothelium"
Urothelium at the US National Library of Medicine Medical Subject Headings (MeSH)
Urothelium at eMedicine Dictionary
Histology at qmul.ac.uk
Diagram at umich.edu
Histology at wisc.edu

UpToDate Contents

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1. 尿路上皮（移行上皮）膀胱癌の疫学および病因 epidemiology and etiology of urothelial transitional cell carcinoma of the bladder
2. 膀胱および泌尿器の転移性尿路上皮癌の治療 treatment of metastatic urothelial cancer of the bladder and urinary tract
3. 腎盂および尿管の悪性腫瘍 malignancies of the renal pelvis and ureter
4. 尿路上皮膀胱癌の初期アプローチおよびマネージメントの概要 overview of the initial approach and management of urothelial bladder cancer
5. Bladder preservation treatment options for muscle-invasive urothelial bladder cancer

English Journal

Agricultural workers and urinary bladder cancer risk in egypt.

Amr S, Dawson R, Saleh DA, Magder LS, Mikhail NN, St George DM, Squibb K, Khaled H, Loffredo CA.Sourcea Department of Epidemiology and Public Health , Baltimore , Maryland , USA.
Archives of environmental & occupational health.Arch Environ Occup Health.2014;69(1):3-10. doi: 10.1080/19338244.2012.719556.
ABSTRACT The authors examined the associations between farming and the risk for squamous cell (SCC) or urothelial cell (UC) carcinoma of the urinary bladder among Egyptians. The authors used data from a multicenter case-control study (1,525 male and 315 female cases, and 2,069 male and 547 female ag
PMID 23930791

Bladder tissue regeneration using acellular bi-layer silk scaffolds in a large animal model of augmentation cystoplasty.

Tu DD, Chung YG, Gil ES, Seth A, Franck D, Cristofaro V, Sullivan MP, Di Vizio D, Gomez P 3rd, Adam RM, Kaplan DL, Estrada CR Jr, Mauney JR.SourceUrological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston, MA 02115, USA.
Biomaterials.Biomaterials.2013 Nov;34(34):8681-9. doi: 10.1016/j.biomaterials.2013.08.001. Epub 2013 Aug 13.
Acellular scaffolds derived from Bombyx mori silk fibroin were investigated for their ability to support functional tissue regeneration in a porcine model of augmentation cystoplasty. Two bi-layer matrix configurations were fabricated by solvent-casting/salt leaching either alone (Group 1) or in com
PMID 23953839

Antitumor T cell responses in bladder cancer are directed against a limited set of antigens and are modulated by regulatory T cells and routine treatment approaches.

Horn T, Grab J, Schusdziarra J, Schmid S, Maurer T, Nawroth R, Wolf P, Pritsch M, Gschwend JE, Kübler HR, Beckhove P.SourceDepartment of Urology, Klinikum Rechts der Isar, Technische Universität München, München, Germany; Translational Immunology Unit, German Cancer Research Center, Heidelberg, Germany.
International journal of cancer. Journal international du cancer.Int J Cancer.2013 Nov;133(9):2145-56. doi: 10.1002/ijc.28233. Epub 2013 Jul 11.
Regulatory T cells (Tregs) play a key role in cancer immune escape. We identified target antigens of spontaneous tumor-specific T cell responses in urothelial carcinoma (UC) and evaluated their modulation by treatment and Treg. We determined Treg target antigens in UC. Fifty-six UC and 13 control pa
PMID 23625723

Japanese Journal

多発骨転移をきたした筋層非浸潤性膀胱癌の1例

佐々木雄太郎,小居浩之,大山拓朗,香川純一郎,小森政嗣,仙崎智一,布川朋也,高橋久弥,武村政彦,山口邦久,山本恭代,井崎博文,高橋正幸,福森知治,金山博臣
泌尿器科紀要 59(10), 669-672, 2013-10-00
… The pathological diagnosis was urothelial carcinoma (UC), grade 2, T1. …
NAID 120005347153

Studer法回腸新膀胱造設術後の尿道再発に対し輸入脚を回腸導管として利用した再尿路変向術の1例

芝政宏,真殿佳吾,辻本裕一,木内利明
泌尿器科紀要 59(10), 677-681, 2013-10-00
… The pathologic diagnosis of transurethral resection was invasive urothelial carcinoma, high grade, G3. …
NAID 120005347151

尿路上皮癌の病理診断―特に平坦病変について―

柳井広之
岡山医学会雑誌 125(2), 113-117, 2013-08-01
NAID 120005317248

Related Pictures

★リンクテーブル★

リンク元	「尿路上皮」「尿路上皮性」「uroepithelial」「urothelium」

「尿路上皮」

Urothelium
	Transitional epithelium of the urinary bladder. Note the rounded surface of the apical cells -- a distinguishing characteristic of this type of epithelium.
	Transverse section of ureter.