The analysis of methylation levels in PTs and PBC samples between patients with exclusively haematogenous dissemination (CTC + LNM-) and those with only lymphogenous spread (CTC-LNM+) identified significant differences between methylation levels of the ADAM23 gene in PTs and the CXCL12 and TWIST1 genes in PBC samples (4.69% vs. 13.39%, P = 0.002; 2.31% vs. 3.03%, P = 0.036; 3.31% vs. 4.48%, P = 0.008). Here, ADAM23 is linked to primary biliary cholangitis.