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% (24/67), with the development of dysplasia showed 14.4% (11/67), the development of intramucosal carcinoma were 3.0% (2/67). Conclusion: Gastric adenomas occur significantly increased nuclear volume, mitotic ＞ 2/10 HPF, irregular 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.