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. 2021 Nov 8;8(1):e000765. doi: 10.1136/bmjgast-2021-000765

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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DGAST shows distinct gene expression compared with PNET. (A) Volcano plot of 203 DEGs in DGAST versus PNET. (B) Heatmap of DGAST versus PNET genes clustered according to significance (p<0.05). Columns and rows were clustered by Z-transformation and Euclidean distance. (C) KEGG pathway enrichment analysis of genes upregulated in DGAST versus PNET. (D) H&E of a DGAST tumour (20×). (E) Magnified H&E of tumour clusters intercalated between thickened stroma. (F) IF with neuroendocrine marker synaptophysin (SYP, red). (G) IF of SYP+ tumour (labelled) stained with enteric glial marker S100B (white arrow, red) and mesenchymal marker α-smooth muscle actin (α-SMA, green). (H) IF of stromal markers showing S100B within DGAST tumour (white arrow). Inset shows IF for SYP staining the tumour. Nuclear stain: DAPI (blue). Genes from (B) organised into heatmaps of (I) transcription factors, (J) signalling pathways or (K) inflammation-related genes upregulated in DGAST versus PNET. DEGs, differentially expressed genes; DGAST, duodenal gastrinoma; IF, immunofluorescence; KEGG, Kyoto Encyclopedia of Genes and Genomes; PNET, pancreatic neuroendocrine tumour. DN-regulated, down-regulated. cAMP, cyclic adenosine monophosphate; cGMP-PKG, cyclic guanosine monophosphate-protein kinase G.