Differentially expressed gene set analysis on PBMCs of both groups showed that SEP without tumor group elevated a number of pro-immunogenic genes involved in T /NK cell functions (TNFAP3, PIM1, LMO2, ATF3, CD69, CD74, IF130, TCF4, and MEF2C)(37–45), while lowering a list of immune suppressive genes (S100A8/9, MMP9, TGFB1, LILR4B, LILRB4A, CCR1, HP, CSF3R, and SOCS1) (Fig. 3C, D)(46–53). This evidence concerns the gene ATF3 and neoplasm.