AKT1 and metastatic neoplasm: As the CIN type of the primary tumor was related to hematogenous metastasis, the SCNAs of the driver genes were mainly observed in patients with hematogenous metastasis; various de novo gain/amps in the metastatic tumors were present, which activate the RTK/RAS, PI3K/AKT, and MYC signaling pathways (Fig. 2a).