PTGS2 and exocrine pancreatic carcinoma: At the transcriptional level, HMGA1 transcription induces the expression of cyclooxygenase 2 (COX‐2) or regulates the insulin receptor to increase cyclin D1 translation and later promotes malignant progression.80, 81 The roles of the phosphatidylinositol 3‐kinase (PI3‐K)/Akt signalling pathway are very important in HMGA1 inducing pancreatic carcinoma.