Renal clear cell carcinoma (RCCC) is a malignant tumor with poor prognosis caused by the high incidence of metastasis to distal organs. Although metastatic RCCC cells frequently show aberrant cytoskeletal organization, the underlying mechanism has not been elucidated. DAL-1/4.1B is an actin-binding protein implicated in the cytoskeleton-associated processes, while its inactivation is frequently observed in lung and breast cancers and meningiomas, suggesting that 4.1B is a potential tumor suppressor. We studied a possible involvement of 4.1B in RCCCs and evaluated it as a clinical indicator. 4.1B protein was detected in the proximal convoluted tubules of human kidney, the presumed cell of origin of RCCC. On the other hand, loss or marked reduction of its expression was observed in 10 of 19 (53%) renal cell carcinoma (RCC) cells and 12 of 19 (63%) surgically resected RCCC by reverse transcription-PCR. Bisulfite sequencing or bisulfite SSCP analyses revealed that the 4.1B promoter was methylated in 9 of 19 (47%) RCC cells and 25 of 55 (45%) surgically resected RCCC, and inversely correlated with 4.1B expression (p < 0.0001). Aberrant methylation appeared to be a relatively early event because more than 40% of the tumors with pT1a showed hypermethylation. Furthermore, 4.1B methylation correlated with a nuclear grade (p 5 0.017) and a recurrence-free survival (p 5 0.0036) and provided an independent prognostic factor (p 5 0.038, relative risk 10.5). These results indicate that the promoter methylation of the 4.1B is one of the most frequent epigenetic alterations in RCCC and could predict the metastatic recurrence of the surgically resected RCCC. ' 2005 Wiley-Liss, Inc.Key words: tumor suppressor gene; bi-sulfite sequencing; two-hit inactivation; recurrence-free survival rate; independent prognostic factor Renal cell carcinoma (RCC) accounts for about 2% of human cancers worldwide, with an incidence of 189,000 and a mortality of 91,000 reported in the year of 2000. 1 Renal clear cell carcinoma (RCCC), which represents 75% of all RCC, exhibits frequent metastasis to distant organs without any clinical symptoms. Furthermore, 40-60% of RCCC tumors without metastasis at first presentation eventually develop metastasis as they progress. 2 Finally, metastatic RCCC becomes refractory to any therapeutic approaches, including chemo-, radio-, and hormonal therapies, resulting in a poor prognosis of patients, with a 5-year survival of less than 10%. 3 Thus, understanding the molecular mechanisms of the development and progression of RCCC is a critical issue for controlling this refractory cancer.Several genetic and epigenetic alterations have been reported in RCCC. The mutation of the VHL gene, associated with loss of heterozygosity (LOH) at the gene locus on chromosomal fragment 3p25-p26, was observed in~50% of sporadic RCCC. 4 Since the VHL encodes a component of an E3 ubiquitin ligase that promotes the degradation of hypoxia-inducible factors, loss of VHL function could be involved in angiogenesis, one of the most characteri...