Although KRAS and NRAS mutations have certain advantages in screening and early diagnosis, their value as single prognostic indicators is limited because they cannot accurately predict survival rates or treatment response in all patients.73,74 In contrast, alterations in SMAD4 not only involve signal pathway regulation but are also closely related to tumor aggressiveness and metastatic potential, offering deeper insights into the biological behavior of the disease. The gene discussed is SMAD4; the disease is neoplasm.