摘要
Objective： The aim of this study was to investigate the clinicopathologic features of gastric adenoma. Methods： Sixty-seven cases of adenoma diagnosis of gastric biopsy specimens using light microscopy, immunohistochemistry, and follow-up methods were studied. Results： Histopathology of gastric adenoma characteristics： nuclear anaplasia, showing increase of nuclear volume and irregular, and the emergence of one or more nucleoli, mitotic ≤ 2/10 high power field （HPF）. Structural changes in the gland： adenoma of the duct much more consistent, sometimes the size of the gland and irregular contour, might be associated with intestinal metaplasia. Increased significantly when the nuclear volume, mitotic 〉 2/10 HPF, irregular gland distortion, branched structures, suggesting the development of adenomas. Immunophenotype： tumor-associated carbohydrate antigens had a higher expression; adenomatous polyposis coli gene （APC） and carcinoembryonic antigen （CEA） expression of closely related with the formation of adenoma. Mucin muc-2 high expression was negatively correlated with muc-1 low expression, the combination of both can help to determine the development and changes in gastric adenoma. Survivin, Bcl-2, p21 and p53 protein expression rare cases, four were combined with the malignant transformation of gastric adenoma was important discriminant. Ki-67 positive cells 20%-40%, and could be used as degree of cell proliferation, a reference indicator of prognosis. Thirty-six to 49 months of follow-up results showed that cured 44.8% （30/67）, there adenomatous hyperplasia 35.8% （24167）, with the development of dysplasia showed 14.4% （11/67）, the development of intramucosal carci- noma were 3.0% （2/67）. Conclusion： Gastric adenomas occur significantly increased nuclear volume, mitotic 〉 2/10 HPF, ir- regular gland distortion, branch-like structure; immunohistochemical staining showed positive expression of muc-2 decreased, muc-1 positive expression; cell proliferation index Ki -67 〉 40%; p21, p53 protein expression occurred, suggesting a tendency to cancer, endoscopic mucosal resection should be as soon as possible.
