To meet this challenge, our study identified a set of genes that predict the development of metastases in ccRCC through the assessment of mRNA expression levels of CA9, NDUF4L2, EGLN3, and BHLHE41, and/or methylation levels of miRNA genes (MIR125B-1, MIR137, MIR375, MIR193A, and MIR34B/C) in the tumor. Here, BHLHE41 is linked to neoplasm.