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Orcein stain for copper-binding protein and immunohistochemistry for cytokeratin 7 (K7) are commonly used to detect signs of chronic cholestasis in the context of chronic biliary disease, particularly at an early stage when bilirubinostasis is lacking and in the non-icteric phase of the disease.1 2 Copper-binding protein deposits and K7 expression by periportal hepatocytes occur in a patchy and heterogenous fashion. In a recent study, we have observed that more than half of 82 periportal regions in 12 liver biopsies from patients with chronic cholangiopathies did not show any stain for copper, copper-binding protein or K7.3 Only a minority (9%) of these periportal regions were positive for rhodanine, orcein and K7 stains. This observation was based on comparing three sections at different levels from each biopsy used for the orcein, rhodanine and K7 stains. Although these sections were cut serially, they were not suitable to investigate whether copper-binding protein deposits and K7 expression were present in the same hepatocytes. We therefore designed a protocol of sequential histochemical (orcein) and immunohistochemical (K7) staining on a single-tissue …
Handling editor Runjan Chetty.
Contributors All authors participated in the design of the study. CS carried out the stain. AQ carried out the analysis. All authors discussed the findings and contributed to the writing and editing of the manuscript.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; internally peer reviewed.