AKT1 and cancer: To explore the cancer signaling pathways associated with PMRI, we performed GSEA analysis in the high PMRI and low PMRI groups, and the results showed that the high PMRI group was significantly enriched in HYPOXIA, IL2_STAT5_SIGNALING, IL6_JAK_STAT3_SIGNALING, INFLAMMATORY_ RESPONSE, INTERFERON_GAMMA_RESPONSE, MTORC1_SIGNALING, and PI3K_AKT_MTOR_SIGNALING signaling pathways, and the above signaling pathways are involved in the regulation of PD-L1 expression levels, so it can be confirmed that PMRI is closely related to PD-L1 expression levels (21) (Figure 5A).