# 肝细胞糖原蓄积与耗竭（Hepatocyte Glycogen Accumulationand Depletion）

- 器官 / 系统：肝 / 肝胆系统（liver / hepatobiliary-system）
- NTP 数据编号：ntp-0412
- 规范 URL：https://www.labsmart.cn/ntp/liver-hepatocyte-glycogen-accumulationand-depletion.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#liver-hepatocyte-glycogen-accumulationand-depletion
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/hepatobiliary-system/liver/Hepatocyte-GlycogenAccumulationandDepletion
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
由于啮齿类动物通常在夜间进食，肝细胞内糖原蓄积的程度一般在清晨时段最高，并在整个白天逐渐减少。

## 病变描述（中文）
由于啮齿类动物通常在夜间进食，肝细胞内糖原蓄积的程度一般在清晨时段最高，并在整个白天逐渐减少。该变化通常累及每个肝小叶内的所有肝细胞（Figure 1、Figure 3）。它最初在小叶中央区肝细胞中消失（Figure 2），并在白天逐渐进展至汇管区周围肝细胞。因此，动物间的比较应考虑剖检时间。Figure 4来自一只在清晨剖检的受试小鼠（与Figure 3来自同一研究）。其肝细胞内糖原明显耗竭。也可能出现超出Figure 1、Figure 3所示程度的糖原过度蓄积。肝细胞内糖原的形态学表现具有特征性，使糖原蓄积或耗竭在多数情况下易于诊断。然而，要获得糖原沉积的明确证据，需要适当的固定和确证性特殊染色。在某些情况下，尤其是当糖原量的差异伴随其他胞质改变时，糖原蓄积或耗竭可能不易辨别。

## 诊断与分级建议（NTP 共识，中文）
在研究内不存在任何与处理相关的变化时，Figure 1、Figure 2、Figure 3所示的糖原程度被视为背景性（自发性）变化，不应作出诊断。相反，若与对照动物相比，受试动物肝细胞内糖原出现与处理相关的增加，则应在受试动物中诊断糖原蓄积并赋予严重程度分级。同样，若存在与处理相关的糖原耗竭（如Figure 4相较于Figure 3），则应在受试动物中诊断糖原耗竭并给予严重程度分级。在毒性研究的背景下，部分受试动物可能食欲下降，与同期对照相比肝脏糖原量减少。因此，对糖原耗竭的判读应考虑采食量和动物总体健康状况。肝细胞糖原量的变化常伴随其他胞质改变，如脂肪变性或胞质空泡化，且糖原含量的改变可能难以与伴随的改变相区分。在这些情况下，诊断为肝细胞胞质空泡化并附严重程度分级是恰当的，但应在病理学描述中详尽描述肝细胞胞质改变的形态学。病理学描述还应包括病理学家关于胞质空泡内容的意见。

## 英文原文 · Comment
Because rodents typically feed at night, the degree of glycogen accumulation within hepatocytes is typically highest in the early morning hours and wanes throughout the day. It also typically involves all hepatocytes in each lobule ( Figure 1 and Figure 3 ). It initially disappears in the centrilobular hepatocytes ( Figure 2 ), with progression to the periportal hepatocytes during the day. Consequently, comparisons among animals should take the time of necropsy into consideration. Figure 4 is from a treated mouse (from the same study as Figure 3 ) that was necropsied in the early morning. There is a notable depletion of glycogen within hepatocytes. Excess glycogen accumulation beyond that present in Figure 1 and Figure 3 may also occur. The morphologic appearance of glycogen in hepatocytes is distinctive, allowing glycogen accumulation or depletion to be readily diagnosed in most cases. However, appropriate fixation and definitive special staining are necessary for unequivocal evidence of glycogen deposition. In some cases, particularly when differences in the amount of glycogen are accompanied by other cytoplasmic changes, glycogen accumulation or depletion may not be easily discerned.

## 英文原文 · Recommendation
In the absence of any treatment-related changes within a study, the degrees of glycogen demonstrated in Figure 1 , Figure 2 , and Figure 3 are considered background (spontaneous) changes and should not be diagnosed. If, in contrast to the control animals, there is a treatment-related increase in glycogen in the hepatocytes, glycogen accumulation should be diagnosed in the treated animals and assigned a severity grade. Likewise, if there is a treatment-related glycogen depletion (as in Figure 4 vs. Figure Figure 3 ), glycogen depletion should be diagnosed in the treated animals and given a severity grade. In the context of a toxicity study, some treated animals may have a depressed appetite and will have decreased amounts of glycogen in the liver, in contrast to the concurrent controls. Consequently, interpretation of glycogen depletion should take food consumption and general animal health into consideration. Changes in the amount of hepatocellular glycogen are frequently accompanied by other cytoplasmic alterations, such as fatty change or cytoplasmic vacuolization, and alterations in glycogen content can be difficult to distinguish from the accompanying changes. In those situations, a diagnosis of hepatocyte cytoplasmic vacuolization is appropriate, along with a severity grade, but the morphology of the cytoplasmic changes in the hepatocytes should be thoroughly described in the pathology narrative. The pathology narrative should also include the pathologist’s opinions regarding the contents of the cytoplasmic vacuoles.

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