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AIM: To explore the potential carcinogenicity of bile from congenital choledochal cyst (CCC) patients and the mechanism of the carcinogenesis in congenital choledochal cyst patients.METHODS: 20 bile samples from congenital choledochalcyst patients and 10 normal control bile samples were usedfor this study. The proliferative effect of bile was measuredby using Methabenzthiazuron (MTT) assay; Cell cycle andapoptosis were analyzed by using flow cytometry (FCM),and the PGE2 levels in the supatant of culturedcholangiocarcinoma cells were quantitated by enzyme-linkedimmunoabsordent assay (ELISA).RESULTS: CCC bile could significantly promote theproliferation of human cholangiocarcinoma QBC939 cellscompared with normal bile (P＝0.001) and negative controlgroup (P＝0.002), and the proliferative effect of CCC bilecould be abolished by addition of cyclooxygenase-2 specificinhibitor celecoxib (20 μM). The QBC939 cells proliferativeindex was increased significantly after treated with 1% bilefrom CCC patient (P＝0.008) for 24 h, the percentage of Sphase (29.48±3.27)% was increased remarkably (P＜0.001)compared with normal bile (11.72±2.70) %, and thepercentage of G0/G1 phase (54.19±9.46) % was decreasedremarkably (P＝0.042) compared with normal bile (69.16±10.88) %, however, bile from CCC patient had no significantinfluence on apoptosis of QBC939 cells (P＝0.719).CONCLUSION: Bile from congenital choledochal cyst patientscan promote the proliferation of human cholangiocarcinomaQBC939 cells via COX-2 and PGE2 pathway.