There was a significant effect of surgery on the levels of circulating soluble immune checkpoints with a significant decrease in circulating levels of soluble PD-1 and LAG-3, in immediate post op setting, which return to baseline 6 weeks post operatively, with similar findings for PD-L2, TIGIT, and TIM-3 and this may reflect removal of their source of production through tumor excision and tumor-infiltrating immune cells. This evidence concerns the gene TIGIT and neoplasm.