PIK3CA and cholangiocarcinoma: Additionally, chronic parasitic hepatic infections, such as those caused by Opisthorchis viverrini and Clonorchis sinensis, promote CCA development by releasing factors such as glutathione S-transferase, granulin, and taurocholate, which in turn hyperactivate the PI3K pathway, thereby stimulating cell proliferation and division [143,144,145].