ABCC3 is an ATP-dependent transporter belonging to the ABC family that actively pumps various substrates across cell membranes 123. It transports glucuronide conjugates (bilirubin diglucuronide, estradiol-17-beta-O-glucuronide), glutathione conjugates (leukotriene C4), and bile salts, functioning as an alternative export route for these compounds from hepatocytes 234. ABCC3 confers resistance to anticancer drugs including methotrexate, etoposide, and teniposide by reducing intracellular drug accumulation 12. Clinically, ABCC3 demonstrates significant disease relevance across multiple malignancies. In glioma, elevated ABCC3 expression predicts shorter overall survival and represents an independent prognostic marker 5. ABCC3 polymorphisms affect survival outcomes in acute myeloid leukemia patients 6 and osteosarcoma patients treated with chemotherapy, with specific alleles correlating with poor chemotherapy response 7. ABCC3 is frequently amplified and overexpressed in HER2-positive breast cancers 8. Additionally, ABCC3 serves as a novel marker of aldosterone-inactive zona glomerulosa cells, distinguishing normal adrenal tissue from aldosterone-producing lesions in primary aldosteronism 9. Expression is regulated by DNA methylation in skin tissue, showing substantial interindividual variability 10.