A cytological study of hepatitis B surface antigen localization using orcein staining in hepatocellular carcinoma

Twenty patients of suspected hepatocellular carcinoma (HCC) were studied to test the hypothesis that orcein staining of cytological specimens from HCC can detect hepatitis B surface antigen (HBsAg). HBsAg status, cytological examination of fine needle aspiration cytology (FNAC) material for diagnosis by Papanicolaou and modified orcein staining for HBsAg were carried out. Observer variability and agreement on orcein positivity was assessed and analyzed using kappa statistics. HCC was diagnosed in 13 patients and 8 were HBsAg positive; 8 had orcein positivity as judged by observer 2 and 7 by observer 1. A significant kappa value of 0.837 suggested a high degree of observer agreement in the interpretation of orcein positivity. This technique is safe and quick and can supplement the histopathological diagnosis of hepatitis B virus associated HCC.