临床与实验病理学杂志2026，Vol.42Issue(1)：14-19,6.DOI:10.13315/j.cnki.cjcep.2026.01.003
十二指肠幽门腺腺瘤10例临床病理及GNAS、KRAS分子特征分析
Duodenal pyloric gland adenoma:clinicopathological analysis and molecular char-acterization of GNAS and KRAS in 10 cases
韦笑 1李琳 1孙琦 1王朝珊 1赵琳玥 1李微1
作者信息
- 1. 南京大学医学院附属鼓楼医院病理科,南京 210008
- 折叠
摘要
Abstract
Objective To investigate the clinicopathological characteristics and molecular genetic features of duodenal pyloric gland adenoma(PGA).Methods Ten cases of duodenal PGA confirmed by endoscopic or laparo-scopic resection were collected.Immunohistochemical staining for MUC6,MUC5AC,MUC2,and Pepsinogen I was performed.Additional β-catenin and p53 staining was conducted in cases with high-grade intraepithelial neoplasia.Sanger sequencing was employed to detect GNAS and KRAS gene mutations in all 10 cases.Results The cohort in-cluded 8 males and 2 females,with a mean age of 61 years(range 30-74 years).The average maximum tumor diam-eter was 2.0 cm(range 0.6-6.0 cm).One case underwent laparoscopic resection,while 9 were treated via endo-scopic resection.Tumors were equally distributed between the duodenal bulb and non-bulbar regions(5 cases each).Pathologically,8 cases exhibited low-grade intraepithelial neoplasia(LGIN),and 2 cases showed LGIN with focal high-grade intraepithelial neoplasia(HGIN).Immunohistochemistry revealed a pure pyloric phenotype in 5 cases and a mixed phenotype in 5 cases,with no foveolar-predominant pattern observed.Aberrant p53 or β-catenin expression was absent.Molecular analysis identified no KRAS mutations in 10 cases,while 1 of 5 tested cases harbored an exon 9 GNAS mutation.Conclusion Duodenal PGA is a rare adenoma subtype with a higher malignant potential compared to other variants,necessitating accurate recognition.Endoscopic resection remains the primary treatment,though fur-ther studies are warranted to elucidate its molecular mechanisms and optimize management strategies.关键词
幽门腺腺瘤/十二指肠/免疫组织化学/分子遗传学Key words
pyloric gland adenoma/duodenum/immunohistochemistry/molecular genetics分类
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韦笑,李琳,孙琦,王朝珊,赵琳玥,李微..十二指肠幽门腺腺瘤10例临床病理及GNAS、KRAS分子特征分析[J].临床与实验病理学杂志,2026,42(1):14-19,6.
