PTGS2 and familial pancreatic carcinoma: Signaling mechanisms involving Hedgehog and Notch, as well as cyclooxygenase 2 (COX-2) have also been implicated in the triggering mechanisms that stimulate the generation of pancreatic cancer from pancreatic inflammation (Maitra et al., 2002; Avila and Kissil, 2013; Hamada et al., 2013).