Liver tissues of 223 autopsy cases of cirrhosis and hepatocellular carcinoma were examined for liver cell dysplasia in relation to hepatitis B surface antigen (HBsAg) detected with orcein stain. Liver cell dysplasia was found in 94 cases (42.2%): 37 were from cases of cirrhosis only, and 53 were from cases of cirrhosis with hepatocellular carcinoma. There was a significant difference in the overall incidence of HBsAg in cases with and without dysplasia (70.2%:32.6%). A similar difference was found in all groups, i.e., those with cirrhosis, cirrhosis with hepatocellular carcinoma, and hepatocellular carcinoma only, in which none of 11 cases of HBsAg negative had dysplasia. A good correlation was seen between the semiquantitative grade of dysplasia and the incidence of HBsAg. These findings suggest a close relationship of HBsAg with liver cell dysplasia.

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.

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Clinical and autopsy findings of a rare condition, carcinoma arising in the wall of an idiopathic choledochus cyst, are reported. Endogeneous carcinogen which is likely to be present in the bile, and coexisting chronic inflammation in the wall of the cyst are assumed to be significant causative factors for the development of carcinoma. The possibility of dysontogenetic development of carcinoma was also discussed.

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