An analysis of 105 autopsy cases (77 male, 28 female) of hepatocellular carcinoma (HCC) showed that 90 cases (85.7%) were associated with liver cirrhosis, of which 75 cases (83.3%) were of the macronodular type. Hepatitis B surface antigen (HBsAg) was detected with orcein stain in the hepatic tissue in 58 cases (55.2%). The incidence of HBsAg in cases of HCC patients with cirrhosis (58.9%) was higher, but not significantly, than that in those without cirrhosis (33.3%). The mean age of HBsAg-positive cases was five years less than that of HBsAg-negative cases, the age distributions therefore being significantly different.
Cancer 49:678-682, 1982.
HE GEOGRAPHICAL DISTRIBUTION of hepatocellular T carcinoma (HCC) varies in different countries of the world. In areas where HCC is common, e.g., parts of Africa and Asia, HCC is frequently associated with macronodular liver cirrhosis, and also with hepatitis B associated antigens or antibodies. The close association between HCC and hepatitis-B virus (HBV) suggests a causal relationship between the two.'.' In Japan, the association between liver cirrhosis and HCC is as frequent as in other Asian and African countries' and a high incidence of HBV infection in patients with HCC has been noted.3 The incidences of liver cirrhosis and HCC differ considerably in different areas of Japan, with high incidences in Tokushima prefecture, Shikoku Island, Southwest Japan. This article reports analysis of the incidence of hepatitis B surface antigen (HBsAg) in 105 cases of HCC autopsied in Tokushima in the 20year period from 1960 to 1979. Shikata's orcein stain' was applied for detecting HBsAg. This simple histochemical method is useful for tissues stored in paraffin blocks or in formalin, especially for retrospective studies on HBV infection." Results obtained with orcein stain have been shown to be as reliable as those obtained by an immunohistochemical method."-15