As summarized in our proposed scheme model in Fig. 10, our data revealed that the enrichment of CAFs was positively associated with cancer stemness and RCC progression, moreover, CAFs-delivered exosomal miR-181d-5p directly targeted RNF43, activated the Wnt/β-catenin signaling, thus enhanced cancer stemness and mediated RCC progression. This evidence concerns the gene RNF43 and cancer.