Then, a four-gene signature related to TEX was established, containing Palladin, Cytoskeletal Associated Protein (PALLD), Member RAS Oncogene Family (RAB31), ADAM Metallopeptidase With Thrombospondin Type 1 Motif 2 (ADAMTS2), and WISP1, which could predict prognosis of patients with CCA. This evidence concerns the gene TEX46 and cholangiocarcinoma.