Progestin Resistance and Corresponding Management of Abnormal Endometrial Hyperplasia and Endometrial Carcinoma

SIMPLE SUMMARY: Patients with endometrial hyperplasia (EH) and endometrial cancer (EC) often fail conservative treatment due to progestin resistance. This article reviews the therapeutic role of progestin in EH and EC as well as the mechanisms of progestin resistance, and systematically expounds potential therapeutic approaches to overcome progestin resistance, thus providing theoretical support for effective treatment strategies. ABSTRACT: With a younger tendency in morbidity age, endometrial cancer (EC) incidence has grown year after year. Worse, even more commonly occurring is endometrial hyperplasia (EH), which is a precancerous endometrial proliferation. For young women with early EC and EH who want to preserve fertility, progestin therapy has been utilized as a routine fertility-preserving treatment approach. Nevertheless, progestin medication failure in some patients is mostly due to progestin resistance and side effects. In order to further analyze the potential mechanisms of progestin resistance in EH and EC, to provide theoretical support for effective therapeutic strategies, and to lay the groundwork for searching novel treatment approaches, this article reviews the current therapeutic effects of progestin in EH and EC, as well as the mechanisms and molecular biomarkers of progestin resistance, and systematically expounds on the potential therapeutic methods to overcome progestin resistance.