{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:33:05Z","timestamp":1787160785519,"version":"build-2736575974"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82071622"],"award-info":[{"award-number":["No. 82071622"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271679"],"award-info":[{"award-number":["82271679"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Engineering Cross Research Program of Shanghai Jiaotong University","award":["No. YG2022QN110"],"award-info":[{"award-number":["No. YG2022QN110"]}]},{"name":"Research Program of the International Peace Maternity and Child Health Hospital affiliated with Shanghai Jiao Tong University School of Medicine","award":["No. CYJH2308"],"award-info":[{"award-number":["No. CYJH2308"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod. Sci."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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\u201350\u00a0years) 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\u201353\u00a0years) 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.<\/jats:p>","DOI":"10.1007\/s43032-026-02141-4","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:32:04Z","timestamp":1784662324000},"page":"1545-1555","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlations between TSC Expression and Menorrhagia in Adenomyosis Patients"],"prefix":"10.1007","volume":"33","author":[{"given":"Ni-Hao","family":"Gu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu-Jing","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nai-Ping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye-Ping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ou-Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Xuan","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Qin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0314-9145","authenticated-orcid":false,"given":"Hong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"issue":"3","key":"2141_CR1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.fertnstert.2018.01.006","volume":"109","author":"S Gordts","year":"2018","unstructured":"Gordts S, Grimbizis G, Campo R. Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis. Fertil Steril. 2018;109(3):380\u20131. https:\/\/doi.org\/10.1016\/j.fertnstert.2018.01.006.","journal-title":"Fertil Steril"},{"issue":"5","key":"2141_CR2","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.rbmo.2017.06.016","volume":"35","author":"S Vannuccini","year":"2017","unstructured":"Vannuccini S, Tosti C, Carmona F, et al. Pathogenesis of adenomyosis: an update on molecular mechanisms. Reprod Biomed Online. 2017;35(5):592\u2013601. https:\/\/doi.org\/10.1016\/j.rbmo.2017.06.016.","journal-title":"Reprod Biomed Online"},{"issue":"10","key":"2141_CR3","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1177\/1933719116650758","volume":"23","author":"CN Herndon","year":"2016","unstructured":"Herndon CN, Aghajanova L, Balayan S, et al. Global transcriptome abnormalities of the eutopic endometrium from women with adenomyosis. Reprod Sci. 2016;23(10):1289\u2013303. https:\/\/doi.org\/10.1177\/1933719116650758.","journal-title":"Reprod Sci"},{"issue":"3","key":"2141_CR4","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1093\/humupd\/dmt052","volume":"20","author":"G Benagiano","year":"2014","unstructured":"Benagiano G, Brosens I, Habiba M. Structural and molecular features of the endomyometrium in endometriosis and adenomyosis. Hum Reprod Update. 2014;20(3):386\u2013402. https:\/\/doi.org\/10.1093\/humupd\/dmt052.","journal-title":"Hum Reprod Update"},{"issue":"1","key":"2141_CR5","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1038\/s41420-022-00821-z","volume":"8","author":"G Li","year":"2022","unstructured":"Li G, Lin Y, Zhang Y, et al. Endometrial stromal cell ferroptosis promotes angiogenesis in endometriosis. Cell Death Discov. 2022;8(1):29. https:\/\/doi.org\/10.1038\/s41420-022-00821-z.","journal-title":"Cell Death Discov"},{"issue":"8","key":"2141_CR6","doi-asserted-by":"publisher","first-page":"2378","DOI":"10.1007\/s43032-021-00513-6","volume":"28","author":"B Yang","year":"2021","unstructured":"Yang B, Gu N, Shi S, et al. Immunoreactivity of plasminogen activator inhibitor 1 and its correlation with dysmenorrhea and lesional fibrosis in adenomyosis. Reprod Sci. 2021;28(8):2378\u201386. https:\/\/doi.org\/10.1007\/s43032-021-00513-6.","journal-title":"Reprod Sci"},{"issue":"Pt 3","key":"2141_CR7","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1042\/bst0310584","volume":"31","author":"CJ Potter","year":"2003","unstructured":"Potter CJ, Pedraza LG, Huang H, et al. The tuberous sclerosis complex (TSC) pathway and mechanism of size control. 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Lancet Respir Med. 2021;9(11):1313\u201327. https:\/\/doi.org\/10.1016\/s2213-2600(21)00228-9.","journal-title":"Lancet Respir Med"},{"issue":"9","key":"2141_CR12","doi-asserted-by":"publisher","first-page":"2543","DOI":"10.1158\/1078-0432.Ccr-07-0321","volume":"14","author":"KH Lu","year":"2008","unstructured":"Lu KH, Wu W, Dave B, et al. Loss of tuberous sclerosis complex-2 function and activation of mammalian target of rapamycin signaling in endometrial carcinoma. Clin Cancer Res. 2008;14(9):2543\u201350. https:\/\/doi.org\/10.1158\/1078-0432.Ccr-07-0321.","journal-title":"Clin Cancer Res"},{"key":"2141_CR13","doi-asserted-by":"publisher","first-page":"710407","DOI":"10.3389\/fcell.2021.710407","volume":"9","author":"NH Gu","year":"2021","unstructured":"Gu NH, Li GJ, Yang BX, et al. Hypo-expression of tuberin promotes adenomyosis via the mTOR1-autophagy axis. 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Informed consent was obtained from all individual participants included in the study.","order":1,"name":"Ethics","label":"Ethical Approval and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None of the authors have any conflicts of interest.","order":3,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}