We observed lower risk scores in stage M0 than in stage M1 and in stage N0 than in stage N1, suggesting that PI3K/AKT signaling is a risk factor for distant pancreatic cancer metastasis, which is consistent with the results that high expression of CDK6 (27), MET (28, 29) and PPP2R3A (Figures 9G–M) promotes tumor metastasis. This evidence concerns the gene AKT1 and familial pancreatic carcinoma.