Prevalence of the hepatitis B surface antigen in various liver diseases among Koreans demonstrated by orcein staining of 614 biopsies

To evaluate prevalence of HBsAg in the liver tissue of various liver diseases among Koreans, a total of 614 cases of liver biopsies; hepatitis (104), cirrhosis (99), hepatocellular carcinoma (78), cholangiocarcinoma (3), metastatic carcinoma (35), HBsAg carrier (15) and miscellaneous (280); were studied by histochemical methods of Shikata's modified orcein, Gomori's aldehyde-fuchsin, aldehyde thionine, Weigert's resorcin-fuchsin, alcian blue, and Verhoeff's elastic staining. It was found that the modified orcein and Gomori's aldehyde-fuchsin methods gave the best and most reliable results. The prevalence of orcein positive materials in various liver diseases showed constantly negative results in acute hepatitis, portal and biliary cirrhosis, cholangiocarcinoma and metastatic tumors, and positive results in 27.5% of chronic persistent hepatitis, 56.8% in chronic active hepatitis, 56% in chronic active hepatitis leading to cirrhosis, 59.5% in adjacent liver tissue of hepatocellular carcinoma, 11.5% in tumor cells of hepatocellular carcinoma, 60% in asymptomatic carriers, and 0.7% in the miscellaneous disease group. The ground glass appearing hepatocytes which were present in various numbers in various liver diseases gave intense positive reaction with orcein staining, especially in asymptomatic carriers. These results strongly indicate that chronic hepatitis, macronodular cirrhosis and hepatocellular carcinoma among Koreans are closely related with hepatitis B virus infection, and the percentage reported here might well be lower than actual prevalence since the specimens are mostly needle biopsy materials and the distribution of orcein positive materials are often spotty.