PIK3CA and neoplasm: Insulin and insulin analogues bind to insulin receptor, insulin-like growth factor receptor and hybrid receptors, activating the mitogen-activated protein kinase signaling pathway (MAPK signaling pathway), phosphatidylinositol 3 kinase signaling pathway (PI3K) and other possible signaling pathways in cells, promote cell mitosis, proliferation and anti-apoptosis, and increased risk of tumor formation and metastasis (27, 28).