This increased expression of HIF1α may account for a part of the aggressive phenotype we have seen in pancreatic cancer cells in-vitro and may shed additional light on the experimental observations of increased cell invasion and marked HIF1α overexpression after exposure to CO2 pneumoperitoneum (which mimics combined hypoxia and hypercapnia) [44,48,49]. This evidence concerns the gene HIF1A and pancreatic neoplasm.