Correlations between TSC Expression and Menorrhagia in Adenomyosis Patients

The TSC complex, formed by the binding of TSC2 with TSC1 and TBC1D7, plays an important role in the onset of endometrial-related diseases through the TSC-mTORC1 axis. However, the relationship between these proteins and adenomyosis has not been determined thus far. Here, we aimed to investigate the expression of TSC proteins in adenomyosis and determine the correlation between TSC expression and clinicopathologic parameters in patients with adenomyosis. 21 patients (age range, 40-50 years) with histologically diagnosed adenomyosis who underwent hysterectomy for nonendometrial disease were enrolled in this study. Specimens of healthy endometria were obtained from 21 patients (age range, 38-53 years) with cervical carcinoma in situ who underwent laparoscopy. The participants were interviewed via a standard questionnaire consisting of items pertaining to sociodemographic characteristics and reproductive history. The severity of dysmenorrhea and menorrhagia was quantified by means of the visual analogue scale and the menstrual pictogram, and preoperative hemoglobin levels were determined. Samples of serum and endometrial tissue were collected, TSC and VEGF expression was determined via immunofluorescence, and VEGF expression in the serum was quantified via ELISA. We found that, in patients with adenomyosis, TSC expression was significantly decreased during the secretory phase. Endometrial TSC1 and TSC2 expression was correlated with menstrual volume. Additionally, high levels of VEGFD increased the likelihood of moderate-to-severe menorrhagia in adenomyosis patients. Our results suggest that TSC is associated with clinical symptoms such as menorrhagia. In addition, VEGFD may be a potential quantitative predictor of the severity of menorrhagia in patients with adenomyosis.