In addition, other authors, based on in vitro models, have analyzed the participation of cytokines in the tumor microenvironment in NB samples in relation to components of the immune response, including macrophages, noting that stage I tumors in NB patients have a high expression of markers associated with M2-type macrophages (IL-4, IL-10, and TGF-β), unlike stage IV tumors, with the expression of IL1-β and TNF-α cytokines associated with poor prognosis [42]. This evidence concerns the gene IL4 and neoplasm.