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Objective　To study the expression and clinical significance of miRNA-145 and OCT4 in endometriosis. Methods　From August 2018 to August 2020, 30 EMs patients (experimental group) and 30 patients with infertility caused by fallopian tube factors （control group) were collected. Ectopic endometrial tissues were collected during operation in experimental group and eutopic endometrial tissues in control group. The expressions of miRNA-145 and OCT4 in ectopic and eutopic endometrial tissues were detected by QPCR, and the expression of OCT4 protein in tissues was detected by Western blot. Results　Compared with non-EMs patients, the expression of miRNA-145 in endometriotic tissues increased (P < 0.01), while the expression of OCT4 decreased （P < 0.01), showing a negative correlation between them. Conclusion　miRNA-145 is expected to be a potential marker for diagnosis of endometriosis. miRNA-145 and OCT4 play a certain role in the occurrence and development of endometriosis, and this finding provides a possible research direction and potential target for the pathogenesis and treatment of EMS. [ABSTRACT FROM AUTHOR]