目的了解肝细胞癌中肝细胞凋亡的形态特征。方法运用透射电镜观察了未经治疗的肝细胞癌及癌旁组织中细胞凋亡的典型、完整的形态学特征。结果凋亡现象出现于单个分散的癌及癌旁组织肝细胞。凋亡的肝细胞体积变小，胞质电子密度增高，细胞表面微绒毛消失，与邻近细胞接触松弛。最早的形态学改变为核染色质分离、浓集，界限清楚紧靠核膜，呈新月形或帽状。线粒体结构尚完好，内质网空泡化，糖原颗粒聚集。继而凋亡细胞以出芽方式形成完整的膜包裹的凋亡小体。已凋亡脱落的凋亡小体被邻近细胞分别吞噬。同时还观察到凋亡小体边形成边被吞噬的现象。结论凋亡小体形成与被吞噬可以是一连续过程。癌旁组织中肝细胞凋亡比癌组织中更常见。未经治疗的肿瘤组织中的细胞凋亡可能对肿瘤的生长起延缓作用 Objective To understand the morphological characteristics of hepatocyte apoptosis in hepatocellular carcinoma. Methods Transmission electron microscopy was used to observe the typical and complete morphological features of apoptosis in untreated hepatocellular carcinoma and adjacent tissues. Results Apoptosis occurred in a single scattered cancer and paracancerous liver cells. The volume of apoptotic hepatocytes becomes smaller, the cytoplasmic electron density increases, the microvilli on the cell surface disappears, and the loose contact with neighboring cells occurs. The earliest morphological changes were the separation and concentration of nuclear chromatin, and the boundaries were clearly close to the nuclear membrane and were crescent-shaped or cap-shaped. The mitochondrial structure is still intact, the endoplasmic reticulum is vacuolated, and the glycogen particles aggregate. The apoptotic cells then sprouted to form intact membrane-wrapped apoptotic bodies. Apoptotic bodies that have fallen out of apoptosis are phagocytized by adjacent cells. At the same time, the phenomenon that the edge of the apoptotic body was swallowed was observed. Conclusion Apoptotic body formation and phagocytosis can be a continuous process. Hepatocyte apoptosis is more common in adjacent tissues than in cancerous tissue. Apoptosis in untreated tumor tissue may delay tumor growth