Likewise, Hepatocellular carcinomas (HCCs) with positive and negative alpha-fetoprotein (AFP) exhibit distinct molecular mechanisms driving lymph node metastasis (LNM): the former is characterized by the activation of the phosphoinositol-3 kinase/protein kinase B (PI3K/AKT) pathway (27) and the upregulation of immune checkpoints, while the latter is predominantly driven by metabolic reprogramming and aberrant Wnt signaling (28). The gene discussed is AFP; the disease is hepatocellular carcinoma.