There are numerous studies that demonstrate that the serum level of MMP-9 is significantly elevated in many types of cancers, including breast cancer, esophageal cancer, and lung cancer [24-26], but previous reports have shown that the incidence of MMP-9 expression in cholangiocarcinoma specimens is only 9–47.5% [15,22]. This evidence concerns the gene MMP9 and cholangiocarcinoma.