The proteome of renal cell carcinoma and non-neoplastic kidney tissue was analysed from 12 patients by two-dimensional polyacrylamide gel electrophoresis to search for differentially expressed proteins in the tumour. Annexin IV was identified to be up-regulated in tumour cells. These patients and further 11 were characterized by RT-PCR. We found an increased amount of annexin IV mRNA. Immunohistochemical analysis revealed an altered localization of annexin IV in tumour cells. Additionally we demonstrate that over-expressed annexin IV promotes cell migration in a carcinoma model system. From these results above it seems possible that annexin IV plays an important role in the morphological diversification and dissemination of the clear cell renal cell carcinoma.