In addition, EUS-guided tissue acquisition (EUS-TA) is necessary to confirm the neuroendocrine nature of the pancreatic lesion and assess the grading of the neoplasia by determining the Ki-67 proliferation index, useful for the decision-making process and associated with 5-years survival of these patients [12,35,36,37,38]. This evidence concerns the gene MKI67 and neoplasm.