Abstract: ObjectiveTo study the gastric mucosal biopsy clinical and pathological features of adenoma, phenotype, biological behavior. MethodsFifty-two patients with pathological diagnosis of gastric biopsy specimens of adenomas were studied by light microscopy, immunohistochemical staining and follow-up methods. ResultsGastric adenoma histopathological characteristics: the nuclear inter-change, reflected increases in size and shape of nuclear irregularity, and the emergence of one or more of the nucleolus, nuclear fission ≤ 2/10HPF. Glands structural change: a tubular adenoma over more consistent, occasional glands of irregular size and contour, may be associated with intestinal metaplasia. When the core volume increased significantly, mitotic>2/10HPF, glands appeared irregular distortions, branching-like structure, suggesting that adenomas and development. Immunophenotype: Different molecular weight keratin and tumor-associated carbohydrate antigens have a higher expression. CDX-2, APC, PTEN, and high expression of CEA is closely related to the formation of adenomas. Mucin Muc-2 high expression of mucin Muc-1 was negatively correlated with low expression, two kinds of combination can help determine the progress of gastric adenoma. survivin, bcl-2 and p53 protein positive expression rate is low, the three pairs of gastric adenomas with malignant transformation of the discriminant of great significance. Ki-67 positive cells 20%~40%, and can be used as degree of cell proliferation, the evaluation a useful indicator of prognosis. 37～45 months follow-up found that cured 42.3% (22/52), there are still adenomatous hyperplasia 38.5% (20/52), with the development of the opposite sex hyperplasia showed 15.4% (8/52), development of mucosal carcinoma in situ were 3.8% (2/52). ConclusionThe emergence of a nuclear volume of gastric adenoma increased significantly, mitotic>2/10HPF, irregular gland distortion and branch-like structure; APC, CDX-2, PTEN, Muc-2 were expression decreased, survivin, bcl-2 and p53 positive expression rates appeared increased, Ki-67 index was increased about 40%, suggesting that there are cancerous tendencies and endoscopic mucosal resection should be required.