European Urology European Urology 42 (2002) 475±480 TraceElementsDistributioninRenalCellCarcinoma DependingonStageofDisease Zygmunt Dobrowolski a,* , Tomasz Drewniak a , Wojciech Kwiatek b , Piotr Jakubik b a Department of Urology, Collegium Medicum Jagiellonian University, 18 Grzegorzecka, 31-531 Krakow, Poland b Institute of Nuclear Physics, Krakow, Poland Accepted 27 August 2002 Abstract Objectives: The aim of this study was to identify those trace elements which can be used to distinguish between normal and malignant tissue in renal cell cancer (RCC) kidney and to assess changes in trace elements concentration in tissue with progressing malignant disease. Methods: In case control study, 36 cases of RCC were analyzed by Synchrotron Radiation Induced X-ray Emission (SRIXE) in order to establish the concentration of 19 elements. Patients with RCC were examined to obtain staging of disease after radical nephrectomy, which was performed in each case. Results were compared with 15 control kidney cortex tissue obtained during autopsy in which cause of death was trauma. Results: The most relevant decrease was detected in Cd content: from 81  39.2 ppm in normal control samples to 16.6  22.2 ppm concentration in RCC. We found that the concentrations of Ti, Pb and Rb were also lower in RCC tissue. On the other hand, the RCC tissue was rich in iron and zirconium. With the progress of malignant disease, assessed by TNM (UICC 1997) scale, lower concentration of S and higher concentration of Ca in both RCC and neoplastic kidney cortex can be seen. The same tendency is observed in Zn and Se concentrations. Cadmium shows raising concentration with progress of RCC only in cortex of neoplastic kidney. In all cases it was shown that the relativelyhightissueconcentrationofironinbothinvestigatedtissuesisdecreasingwiththeprogressofdisease.The zirconium has shown raising tissue concentration in advanced disease. Conclusion: Trace elements concentration is different in malignant tissue and surrounding macroscopically unchanged kidney cortex. Progress of the disease is connected with changes in trace elements concentration. This may re¯ect different biology of compared tissue with potential practical implication. # 2002 Published by Elsevier Science B.V. Keywords: Renal cell carcinoma (RCC); Trace elements; Carcinogenesis 1. Introduction Metals are an important and emerging class of carci- nogen [3]. Many metals are potent carcinogen in labora- tory animals [13]. A few are potent carcinogen and several are suspected human carcinogen [4]. Metals are ubiquitous in both natural environment and work place. Beyond this, metals are typically persistent within the natural and man-made environment with growing con- centration in biosphere [11]. Often metallic carcinogens are highly tissue speci®c and are often related to high concentration at the target organ. It is thought that non- essential metals, including the carcinogenic metals, often follow the metabolic pathway of similar essential metals and frequently disrupts their metabolisms and function [16]. It is growing awareness of renal cell cancer (RCC). In United States of America, death rates from RCC have increased during the last 30 years by 35% in men, and by 20% in women [2]. There is considerable variation of both incidence and mortality in different countries. The highest rates of both have been found in developed country [4,11]. Information of trace elements as risk factor for RCC is limited, but suggesting that cadmium could play a major role in the development of RCC [1,17]. The aim of this study was * Corresponding author. Tel. 48-12-424-7950; Fax: 48-12-422-9244. E-mail address: zdobrowol@psk.cm-uj.krakow.pl (Z. Dobrowolski). 0302-2838/02/$ ± see front matter # 2002 Published by Elsevier Science B.V. PII:S0302-2838(02)00400-1