VHL and nonpapillary renal cell carcinoma: However, it was reported that there is no difference in survival between patients carrying wild-type or mutant VHL or between patients with different levels of either VHL protein or messenger RNA (mRNA), and patients with nonsense mutations in exon 1 have a worse prognosis based on a study of ccRCC patients from Brazil (15), suggesting that loss of VHL function is directly related to the prognosis of ccRCC patients.