It is known that the concentration and activity of the DNA precursor enzyme thymidine kinase 1 (TK1) in serum is significantly elevated in patients with malignancies, as compared with levels in patients with benign tumours and those in healthy individuals. For the first time, the use of serum TK1 as a prognostic marker for patients with renal cell carcinoma (RCC) was examined. Serum TK1 protein (STK1p) concentration and serum TK1 activity (STK1a) were determined by a dot blot chemoluminescence assay and a radio enzyme assay, respectively. There was no correlation between STK1p and STK1a in the same sera from 27 RCC patients. Only one STK1p value as compared with 15 STK1a values was clearly above the cut-off values (2 pmol/l and 6 U/l, respectively) for healthy individuals. STK1a values did not correlate with the level of TK1 expression in tumour sections from the RCC patients, estimated by immunohistochemistry staining. However, there was a significant correlation between STK1a levels and the grade, stage and size of the RCC tumours. The discrepancy between the STK1p and the STK1a results is likely to be because of reduced ability of the TK1 antibody to recognize the STK1 in sera from RCC patients. We conclude that the activity of STK1 is a useful tool for evaluating the prognosis of patients with RCC.