近年来我国子宫内膜癌发病率逐年上升，发病年轻化，早期子宫内膜癌的年轻患者保留生育功能的诉求日益强烈。目前孕激素治疗仍是保育治疗的首选，且已取得较好效果。但孕激素耐药和不良反应也成为部分患者孕激素治疗失败的主要原因。因此了解孕激素耐药机制及探究应对方法对于早期子宫内膜癌患者保育治疗具有指导意义。该文主要针对孕激素治疗发生耐药的机制、解决孕激素耐药的新型治疗方法（如宫腔镜）以及子宫内膜癌分子分型对预测孕激素耐药的指导意义进行综述。

The incidence of endometrial cancer among Chinese women has increased year by year with a younger trend in morbidity age. Young patients with early endometrial cancer are increasingly demanding fertility preservation. At present, progesterone therapy is still the first choice of fertility-sparing treatment, and has achieved good results. However, progesterone resistance and adverse reactions have also become the main reasons for the failure of progesterone therapy in some patients. Therefore, understanding the mechanism of progesterone resistance and exploring coping methods has guiding significance in the fertility-sparing treatment for early endometrial cancer patients. This article reviews the mechanism of progesterone resistance, the new treatment methods to solve progesterone resistance (such as hysteroscopy), and the significance of molecular typing of endometrial cancer in predicting progesterone resistance.