title: Effects of levonorgestrel-releasing intrauterine system on lymphangiogenesis of adenomyosis.
abstract: OBJECTIVE
  Lymphangiogenesis may be involved in the pathogenesis of adenomyosis. We investigated the lymphatic vessels of patients with adenomyosis, including those treated with levonorgestrel-releasing intrauterine system (LNG-IUS).
  
  
  METHODS
  Full-thickness uterine samples were obtained from patients who received hysterectomies. Twenty-one patients with adenomyosis and 17 patients with adenomyosis who were treated with LNG-IUS were included. Eighteen patients with cervical intraepithelial neoplasia served as controls. Immunohistochemical staining was performed with antibodies against podoplanin and lymphatic vessel endothelial hyaluronan receptor 1. The lymphovascular density (LVD) was analyzed in each sample by the "hot spot" method.
  
  
  RESULTS
  The LVDs were significantly higher in the endometrial and myometrial tissues of patients with adenomyosis compared with those of patients treated with the LNG-IUS or controls. No significant differences were noted between the LNG-IUS-treated group and controls. Evaluation of the LVDs according to the menstrual cycle showed that the differences in the endometrial tissues of the adenomyosis group and those of the LNG-IUS-treated group or the controls were more prominent during the secretory phase.
  
  
  CONCLUSIONS
  Treatment with the LNG-IUS resulted in reduced lymphangiogenesis and LVD in the endometrial and myometrial tissues of patients with adenomyosis. Reduced lymphangiogenesis may be one mechanism by which the LNG-IUS reduces adenomyosis-related symptoms.
authors.affiliation: From the Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: SiHyun
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Sik
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;
authors.forename: Bo Hyon
authors.initials: BH
authors.lastname: Yun
authors.affiliation: Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;
authors.forename: Seung Joo
authors.initials: SJ
authors.lastname: Chon
authors.affiliation: Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Department of Obstetrics and Gynecology, YongIn Severance Hospital, Yonsei University College of Medicine, YongIn City, Kyunggi-do, Korea; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: HyeYeon
authors.initials: H
authors.lastname: Kim
authors.affiliation: From the Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seok Kyo
authors.initials: SK
authors.lastname: Seo
authors.affiliation: Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; and paxco@yuhs.ac dr222@yuhs.ac.
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: From the Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea. paxco@yuhs.ac dr222@yuhs.ac.
authors.forename: Byung Seok
authors.initials: BS
authors.lastname: Lee
mesh_terms: D062788:Adenomyosis / Q000188:drug therapy / Q000473:pathology*; D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000627:therapeutic use; D042583:Lymphangiogenesis / Q000187:drug effects*
chemical_list: D016912:Levonorgestrel
keywords: Adenomyosis; D2-40; LYVE-1; Levonorgestrel-releasing intrauterine system; Lymphangiogenesis