The differentiation between chronic pancreatitis and pancreatic cancer is one of the clinical difficulties, especially pancreatic tumors occurring on the basis of chronic pancreatitis, which are often difficult to be recognized early by imaging, and the diagnostic sensitivity and accuracy of EUS and ultrasound endoscopy-guided fine-needle aspiration (EUS-FNA) are still debatable. Some researchers have reported that the detection rate of pancreatic cancer can be improved by using various methods such as contrast-enhanced EUS (CE-EUS) and new image analysis systems, among which the re-imaging of raw data from RAW images is particularly interesting. A total of 10 cases of chronic pancreatitis and 28 cases of pancreatic cancer were included in the study. The results showed that compared with EUS/EUS-FNA, re-imaging has significant advantages in the diagnosis of chronic pancreatitis and pancreatic cancer, and it is more likely to find occupying foci in the inflammatory parenchyma, and it also can make the tumor boundary clearer, and the disadvantage is that the imaging needs post-analysis, and it can’t be used for real-time dynamic detection. Mayo Hospital scholars introduced the experience of using ultrasound endoscopy-guided fine needle injection (EUS-FNI) technology to inject gemcitabine intratumorally for the treatment of pancreatic cancer, the study included a total of 34 cases of patients with progressive pancreatic cancer (Stage III/IV), with an average injection dose of 2.5 ml (40 mg/ml), and conventional chemotherapy 4-14 days after the injection, and the preliminary study concluded that the intra-tumoral injection of gemcitabine can effectively reduce tumor stage and may help prolong survival. Prof. Giovannini has reported the diagnostic value of a small confocal probe in 37 patients with choledochal obstruction, and the feasibility of ultrasonography-guided confocal endoscopy (EUS-CM) has been confirmed in animal studies. In this meeting, he also reported the application of this technique in 7 cases of pancreaticobiliary and mediastinal lymph nodes and other occupying lesions. After obtaining tissues by EUS-FNA with a 19G puncture needle, the confocal small probe was placed into the tumor for confocal imaging, and the histological results were compared with those of EUS-FNA, and it was found that EUS-CM was valuable in identifying the type of the tumor and the nature of the enlarged lymph nodes. EUS has a very important role in the diagnosis and management of pancreatic cystic disease and follow-up, especially the use of EUS-FNA to obtain cystic fluid or solid tissue can help to clarify the nature of the lesion. Some researchers performed puncture in pancreatic cystic lesions with a diameter greater than 2 cm, obtained about 0.5 ml of cystic fluid and analyzed it, and determined the expression of 16 related microRNAs (miRNAs), which showed that the different expression of related miRNAs in the cystic fluid may be helpful to identify pancreatic cystic lesions with different natures, such as pancreatic intraductal papillary mucinous neoplasia (IPMN) and mucinous cystic neoplasms (MCN), etc. However, the sample size of this study is very large, and it is not possible to determine the nature of cystic lesions, especially in the case of EUS-FNA. lesions, but the sample size of this study was small and the specificity of the selected miRNAs remains to be explored.