Additionally, it was also reported thatC. sinensis ESPs played important roles in promoting the progression of CCA through the interaction between normal cholangiocytes and CCA cells, which might be mediated by the extracellular signal-regulated kinase 1/2/NF-κB/matrix metalloproteinase-9 and integrin β4-focal adhesion kinase/steroid receptor coactivator pathways[93–94]. This evidence concerns the gene MMP9 and cholangiocarcinoma.