Demonstration of hepatitis B surface antigen by orcein staining in paraffin sections of cirrhotic liver.

Blood and liver from 44 and 30 patients, died in cirrhosis and other diseases, respectively were tested for the presence of HBSAg. Blood samples obtained at autopsy and in seven cirrhosis cases also before death were tested for HBSAg by counter-electrophoresis. Detection of HBSAg in hepatocytes was carried out in paraffin sections by the modified orcein staining technique of Shikata et al. Ten of 14 HBSAg seropositive and 2 of 30 HBSAg seronegative cirrhotic patients had orcein positive hepatocytes, which were not found in any liver specimen from the 30 non-cirrhotic seronegative patients. The orcein positive substance localized in the cytoplasm of hepatocytes, less often it was also seen in a few Kupffer cells. The hepatocellular carcinoma cells present in part of the livers studied did not contain any orcein positive substance. Histological changes in the cirrhotic livers showed morphological indication of the presence of HBSAg, except on staining with orcein. The modified orcein staining technique is a simple, handy procedure for use in any routine pathological laboratory and has the additional advantage of detecting HBSAg also in stored paraffin blocks.