BRCA1 and cholangiocarcinoma: In a recent study of genomic and epigenetic analyses of 489 patients with CCA [17], fluke-positive CCA specimens showed significant enrichment in genetic mutations of the TP53, ARID1A, and BRCA1/2 genes, in contrast to fluke-negative CCA showing mutations in the IDH1/2 and BAP1 epigenetic modifier genes, suggesting a bias towards selection of specific cancer mutations during fluke-associated CCA progression.