TNF and metastatic malignant neoplasm in the lymph nodes: The mean value of serum TNF-α in patients with lymph node metastasis from gastric cancer was nearly 6-fold higher than normal, and the mean value of serum TNF-α in patients with postoperative recurrence was nearly 3-fold higher than normal, which may be due to increased tumor load and excessive release of TNF-α from activated lymphocytes in vivo, resulting in increased serum TNF-α levels [38].