Myeloid-derived suppressor cells and macrophages recruited to the tumor microenvironment from the bone marrow by tumor cells and Tregs are also potent suppressors of anti-tumor immunity, when they are converted to an immunosuppressive phenotype by cytokines such as IL-10, which was found to increase perioperatively in our study and TGF-β (36) which are secreted by tumor tissue as well as other immune and stromal cells to promote recruitment and suppression of many immune cell types (37). This evidence concerns the gene TGFB1 and neoplasm.