Abstract：
For pancreatic solid lesions, ESGE recommends performing endoscopic ultrasound (EUS)-guided sampling as first-line procedure when a pathological diagnosis is required. Alternatively, percutaneous sampling may be considered in metastatic disease.Strong recommendation, moderate quality evidence.In the case of negative or inconclusive results and a high degree of suspicion of malignant disease, ESGE suggests re-evaluating the pathology slides, repeating EUS-guided sampling, or surgery.Weak recommendation, low quality evidence.In patients with chronic pancreatitis associated with a pancreatic mass, EUS-guided sampling results that do not confirm cancer should be interpreted with caution.Strong recommendation, low quality evidence.For pancreatic cystic lesions (PCLs), ESGE recommends EUS-guided sampling for biochemical analyses plus cytopathological examination if a precise diagnosis may change patient management, except for lesions ≤ 10 mm in diameter with no high risk stigmata. If the volume of PCL aspirate is small, it is recommended that carcinoembryonic antigen (CEA) level determination be done as the first analysis.Strong recommendation, low quality evidence.For esophageal cancer, ESGE suggests performing EUS-guided sampling for the assessment of regional lymph nodes (LNs) in T1 (and, depending on local treatment policy, T2) adenocarcinoma and of lesions suspicious for metastasis such as distant LNs, left liver lobe lesions, and suspected peritoneal carcinomatosis.Weak recommendation, low quality evidence.For lymphadenopathy of unknown origin, ESGE recommends performing EUS-guided (or alternatively endobronchial ultrasound [EBUS]-guided) sampling if the pathological result is likely to affect patient management and no superficial lymphadenopathy is easily accessible.Strong recommendation, moderate quality evidence.In the case of solid liver masses suspicious for metastasis, ESGE suggests performing EUS-guided sampling if the pathological result is likely to affect patient management, and (i) the lesion is poorly accessible/not detected at percutaneous imaging, or (ii) a sample obtained via the percutaneous route repeatedly yielded an inconclusive result.Weak recommendation, low quality evidence.
摘要：
对于胰腺实性病变，当需要病理诊断时，ESGE建议将内窥镜超声（EUS）引导的采样作为一线程序。或者，在转移性疾病中可以考虑经皮取样。强烈推荐,中等质量的证据。在阴性或不确定结果以及高度怀疑恶性疾病的情况下，ESGE建议重新评估病理切片，重复EUS引导采样，或手术。弱推荐,证据质量低。在与胰腺肿块相关的慢性胰腺炎患者中，EUS指导的采样结果不确认癌症应谨慎解释。强烈推荐,证据质量低。对于胰腺囊性病变（PCL），如果精确诊断可能改变患者管理，ESGE建议采用EUS引导采样进行生化分析和细胞病理学检查。除了直径≤10毫米的病变，没有高风险的柱头。如果PCL抽吸物的体积很小，建议首先进行癌胚抗原（CEA）水平测定。强烈推荐,证据质量低。对于食道癌，ESGE建议进行EUS引导的采样以评估T1区域淋巴结（LN）（以及，根据当地的治疗政策，T2)腺癌和可疑转移的病变，如远处LN，左肝叶病变,和疑似腹膜癌。弱推荐,证据质量低。对于不明原因的淋巴结病，如果病理结果可能影响患者的治疗，并且不容易获得浅表淋巴结病，则ESGE建议进行EUS引导（或支气管内超声[EBUS]引导）采样。强烈推荐,中等质量的证据。在可疑转移的实体肝肿块的情况下，如果病理结果可能影响患者管理，ESGE建议进行EUS引导的采样。和（i）在经皮成像时，病变难以接近/未检测到，或（ii）通过经皮途径获得的样品反复产生不确定的结果。弱推荐,证据质量低。
