St James's Hospital, Dublin 8, Ireland.
Hum Pathol. 2013 Apr;44(4):636-42. doi: 10.1016/j.humpath.2012.07.014. Epub 2012 Oct 11.
Duodenal gastric heterotopia (DGH) is a common incidental finding at endoscopy, generally assumed to be congenital in origin. A recent study has suggested a possible association with gastric fundal gland polyps (FGPs). In this review of 37 patients with histologically confirmed DGH, the background to our present understanding of the DGH lesion is reviewed, the clinical and pathological associations of the condition in our cohort are identified, and the histological and immunohistochemical features of the DGH lesion are described. An association with the presence of FGPs is again demonstrated, whereas an inverse relationship with Helicobacter pylori is also shown. Immunohistochemical staining demonstrates that the fundic-type glands of DGH express the proton pump antigen (H(+)K(+)ATPase), whereas the overlying surface mucosa expresses the mucin profile of normal gastric-type mucosa (mucin-5AC positive, mucin-2 negative). DGH may represent a further component of the iatrogenic hypergastrinemia-related hypothesis for FGP development, although further study is required to confirm this.
十二指肠胃异位（DGH）是内镜检查中的常见偶发发现，通常被认为是先天的。最近的一项研究表明，它可能与胃底腺息肉（FGPs）有关。在对 37 名经组织学证实的 DGH 患者的回顾中，我们回顾了目前对 DGH 病变的理解背景，确定了我们队列中该病症的临床和病理关联，并描述了 DGH 病变的组织学和免疫组织化学特征。再次证明了与 FGPs 存在的关联，而与幽门螺杆菌的关系则相反。免疫组织化学染色表明，DGH 的胃底型腺体表达质子泵抗原（H(+)K(+)ATPase），而覆盖的表面黏膜表达正常胃型黏膜的黏蛋白谱（黏蛋白-5AC 阳性，黏蛋白-2 阴性）。DGH 可能代表了与 FGPs 发展相关的医源性高胃泌素血症假说的另一个组成部分，尽管需要进一步研究来证实这一点。
