Inflammation of the bile duct, autoimmune disorders, parasitic infections and exposure to alcohol or toxins contributes to BTC pathogenesis.9,14 These inflammatory conditions upregulate cytokines such as interleukin-6 (IL-6), granulocyte macrophage colony-stimulating factor (GM-CSF), and transforming growth factor-β (TGF-β), yet specific mechanisms by which these cytokines influence tumour development and progression in BTC have yet to be described. This evidence concerns the gene CSF2 and parasitic infectious disease.