Data regarding oxidatively modified DNA bases suggest that cancer cells are more exposed to oxidative stress than adjacent non-tumorous tissue. This novel concept may contribute to the understanding of certain aspects of tumor biology such as activated transcription factors, genetic instability, chemotherapy-resistance and metastasis. We therefore tested this concept in human renal-cell carcinomas (RCCs) by evaluating the expression of hMTH1, an enzyme preventing the misincorporation into DNA of 8-0x0-dGTP (8-oxo-7,8-dihydrodeoxyguanosine triphosphate), an oxidized form of dGTP in the nucleotide pool. The expression of hMTHl messenger RNA (mRNA) in RCC was significantly higher than that in adjacent nontumorous kidney. Moreover, advanced-stage tumors showed significantly higher hMTHl mRNA expression than early-stage tumors, and there was a modest linear correlation between hMTHl expression and c-myc expression. The results provide logical support for the concept of "persistent oxidative stress in cancer" and suggest a role of hMTHl mRNA level as a prognostic marker.o 1996 Wiley-Liss, Inc.It is generally accepted that reactive oxygen species (ROS) play a role in carcinogenesis by inducing mutagenic modifications in DNA (Halliwell and Gutteridge, 1989; Halliwell and Aruoma, 1993). However, ROS in tumor biology is a research area not intensively investigated so far. We recently measured in human renal-cell carcinoma (RCC) the amount of 8-0x0-2'-deoxyguanosine (8-0x0-dG, also called 8-hydroxy-2'-deoxyguanosine), a mutation-prone DNA base created by ROS (hydroxyl radical, singlet oxygen or direct photodynamic action) (Kasai and Nishimura, 1984; Kasai et al., 1992; Halliwell and Aruoma, 1993), and found significantly higher levels of 8-0x0-dG in RCC than in adjacent non-tumorous tissue at various stages of the disease (Okamoto et al., 1994). Based on our study and those of others, we hypothesized a concept of "persistent oxidative stress in cancer" that may contribute to aspects of tumor biology such as activated transcription factors and proto-oncogenes, genetic instability, chemotherapyresistance and metastasis (Toyokuni et al., 1995). A study was undertaken to test this hypothesis.At least 2 different metabolic pathways for the presence of 8-0x0-dG in DNA have been established (1) direct hydroxylation of C-8 of dG in DNA that causes a G:C to T A transversion upon replication (Kuchino et al