Furthermore, Ellis et al reviewed all of the published ASPL-TFE3 as well as PRCC-TFE3 RCC cases and found that ASPL-TFE3 RCC usually presents at an advanced stage.27 Ellis's group found that regional lymph nodes were involved in 24 of the 32 ASPL-TFE3 RCC cases and that patients who had distant metastasis also displayed ASPL-TFE3 fusion genes. This evidence concerns the gene PRCC and renal cell carcinoma.