Fujii et al., in a study focusing on distal gastrectomy for gastric cancer, showed that laparoscopic procedure is followed by increased INF-γ but stable IL-4, compared with the open group, where there is significant decrease of INF-γ and increase of IL-4, suggesting that the laparoscopic approach may be related to better Th1 function, while the open approach clearly leads to activation of Th2 mediated immunity and B cell stimulation [40]. This evidence concerns the gene IL4 and gastric cancer.