Detection of hepatitis B surface antigen by means of orcein staining of liver.

Paraffin-embedded sections of liver biopsies from 65 patients and 16 autopsies were stained by a modified orcein method as described by Shikata, to appraise the efficacy of the method in detecting hepatitis B antigen, (HGsAg). Of the liver biopsies from patients with chronic hepatitis, 55% were positively stained. Staining was observed in the cytoplasm of liver cells but was frequently irregular in distribution. The technic is simple and may be used for evaluation of fresh or stored liver. The positive stain is of value in the diagnosis of chronic hepatitis with minimal or absent histologic changes, as well as the distinction of chronic from acute hepatic disease. The method may be useful for detecting asymptomatic carriers. However, weak positive staining of hepatic parenchyma should be evaluated with caution when serologic tests for HBsAg are negative. It may warrant repeated serologic testing. Evaluation of stored autopsy material suggests that Shikata's stain may also be used in determining the etiology of cirrhosis. Inclusion bodies seen in hepatomas stain positively with orcein, suggesting that they contain, or are related to, HBsAg.