Objective To analyze the histopathological and gene expression changes of villus in patients with missed mis-carriage,and explore the mechanism of missed miscarriage.Methods Patients with induced abortion from December 2020 to February 2023 from the First Affiliated Hospital of Anhui Medical University were selected to participate in the study,including 35 cases of missed abortion in the study group and 35 cases in the control group.The pathological chan-ges of villus tissue were observed by HE staining and transmission electron microscopy,and the sequencing results and CXCL9 gene expression changes were verified by RNA sequencing and qRT-PCR.Results In the study group,the num-ber of HE chromatozytial trophoblasts decreased and inflammatory cells infiltrated,and fluoroscopy electron microscopy showed that the endoplasmic reticulum of cytotrophoblasts expanded,the number of mitochondria in syncytial trophoblast decreased and the number of Hofbauer cells increased.The most significant up-regulated genes were KRT34(FDR=0.008),MRGPGR(FDR=0.048),CUZD1(FDR=0.002),CXCL9(FDR＜0.001),CD72(FDR=0.043),FGF14(FDR=0.042),TMEM176A(FDR＜0.001),and GAPT(FDR=0.026).qRT-PCR showed that the expression of KRT34,MRGPGR,CUZD1,CXCL9,CD72,FGF14,TMEM176A and GAPT genes was up-regulated,and the all P＜0.05,while the mRNA expression of CXCL9 in the study group(28.66±0.38)and the control group(27.46±0.75)were significantly different(P＜0.001).Conclusion Inflammatory cell infiltration and up-regulation of CXCL9 expres-sion may play an important role in the development of missed miscarriage.
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