癌症是由遗传驱动的叛逆细胞组织，通过劫持正常的稳态程序生成功能障碍、顽固不化的器官。凋亡是一种进化保守的调控性细胞死亡程序，是在积极生长的癌症以及对细胞毒性抗癌治疗有反应的肿瘤中常见的（与肿瘤细胞增殖一起）。尽管凋亡以其细胞自主的抗肿瘤特性而闻名，但凋亡具有通过非细胞自主机制发挥促癌特性的能力，这些特性通常定义不清。本文综述了凋亡在肿瘤生物学中的作用，特别关注凋亡肿瘤细胞分泌和碎裂产物对肿瘤相关巨噬细胞的影响，后者是肿瘤微环境中异常稳态的关键支持性细胞。考虑了肿瘤生长动力学中细胞丧失的历史因素，并从炎症、组织修复和再生计划的角度讨论了凋亡细胞清除（目标吞噬作用）以及释放的可溶性和细胞外囊泡相关因子对肿瘤生长的影响和潜在影响。提出了一个“凋亡中心”观点，即垂死的肿瘤细胞为生长中的癌症提供了一个重要的细胞间通信网络平台。该观点对未来的研究以及改善癌症诊断和治疗具有重要意义。© 2023 The Author. 由John Wiley & Sons Ltd.发表的《免疫学评论》。

Cancers are genetically driven, rogue tissues which generate dysfunctional, obdurate organs by hijacking normal, homeostatic programs. Apoptosis is an evolutionarily conserved regulated cell death program and a profoundly important homeostatic mechanism that is common (alongside tumor cell proliferation) in actively growing cancers, as well as in tumors responding to cytotoxic anti-cancer therapies. Although well known for its cell-autonomous tumor-suppressive qualities, apoptosis harbors pro-oncogenic properties which are deployed through non-cell-autonomous mechanisms and which generally remain poorly defined. Here, the roles of apoptosis in tumor biology are reviewed, with particular focus on the secreted and fragmentation products of apoptotic tumor cells and their effects on tumor-associated macrophages, key supportive cells in the aberrant homeostasis of the tumor microenvironment. Historical aspects of cell loss in tumor growth kinetics are considered and the impact (and potential impact) on tumor growth of apoptotic-cell clearance (efferocytosis) as well as released soluble and extracellular vesicle-associated factors are discussed from the perspectives of inflammation, tissue repair, and regeneration programs. An "apoptosis-centric" view is proposed in which dying tumor cells provide an important platform for intricate intercellular communication networks in growing cancers. The perspective has implications for future research and for improving cancer diagnosis and therapy.© 2023 The Author. Immunological Reviews published by John Wiley & Sons Ltd.