AIM:To detect the expression of caspase 3 gene in primary human hepatocellular carcinoma (HCC) and investigate its relationship top21(WAF1) gene expression and HCC apoptosis.METHODS:In situ hybridization was employed to determine caspase 3 and p21(WAF1) expression in HCC.In situ end-labeling was used to detect hepatocytic apoptosis in HCC.RESULTS:Twenty-one of 39 (53.8%) cases of HCC were found to express caspase 3 transcripts, while 46.2% of HCC failed to express caspase 3.Non-cancerous adjacent liver tissues showed more positive caspase 3(87.5%, 7/8) as compared with HCC (p < 0.05). The expression of caspase 3 is correlated with HCC differentiation, 72.2% (13/18) of moderately to highly differentiated HCC showed caspase 3 transcripts positive, while only 38.1% of poorly differentiated HCC harbored caspase 3 transcripts (italic>p < 0.05). No relationship was found between caspase 3 expression and tumor size or grade or metastasis, although 62.5% (5/8) of HCC with metastasis were caspase 3 positive and a little higher than that with no metastasis (51.6%, p> 0.05). Expression of caspase 3 alone did not affect the apoptosis index (AI) of HCC. The AI was 7.12 in caspase 3 positive tumors (n = 21), while in caspase 3-negative cases (n = 18) 6.59 (italic>p > 0.05). Expression of caspase 3 clearly segregated with p21(WAF1) positive tumors as compared with p21(WAF1) negative cases (16 of 23, 69.6% versus 5 of 16, 31.3%) with statistical significance (p = 0.017).In the cases with positive caspase 3 and negative p21(WAF1), the AI was found slightly higher, but with no statistical significance, than that with expres-sion of p21(WAF1) and caspase 3 (7.21 vs 6.98 , p>0.05).CONCLUSION:Loss of caspase 3 expression may contribute to HCC carcinogenesis, although the expression of caspase 3 does not correlate well with cell apoptosis in HCC.p21(WAF1) may be merely one of the inhibitors which can reduce caspase 3 mediated cell apoptosis in HCCs.