However, a large number of studies have found Tumor Mutational Burden (TMB) (9, 10), derived neutrophil to lymphocyte ratio (dNLR) (4), serum tumor markers (such as encompass carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin fragment 21-1 (Cyfra21-1) and carbohydrate antigen (CA19-9) (11)have predictive significance. This evidence concerns the gene CEACAM5 and neoplasm.