RTK is a class of cell surface receptors that responds to environmental signals by initiating appropriate signaling cascades in tumor cells and regulates various downstream signaling pathways including MAPK, PI3K/Akt, etc. (37) Our results showed no significant difference in RTK (EGFR, VGFR) activity between patients in different groups, but its downstream signaling pathway (MAPK, PI3K/Akt) was higher in high-risk group patients. This evidence concerns the gene AKT1 and neoplasm.