Tumor-associated macrophages interact with cancer cells and promote tumor progression by producing various cytokines and chemokines, such as IL-6 and tumor necrosis factor-α.[39,40] In addition, monocytes and their progeny have immunosuppressive, which also promotes tumor angiogenesis, tumor-cell invasion, and metastasis.[41] Similar to the results of prior studies,[42] a strong association between the pretreatment monocyte count and a poor prognosis for GBC patients was found in this study. This evidence concerns the gene TNF and cancer.