Next, the survival analysis indicated that cigarette smoke exposure-reduced genes ANKRD12, CYB5A, ECHDC3, DCN, HOXC10 and cigarette smoke exposure-promoted gene AKT1S1 showed the positive and negative relationship with overall survival in KIRC, which was accord with some studies that decreased ANKRD12 and CYB5A and increased AKT1S1 expression show a higher frequency of tumor metastasis and are indicators of increased risk of tumor progression25–27. This evidence concerns the gene DCN and neoplasm.