Tehranian Afsaneh, Alambeygi Hanieh, Abbasi Sheida, Ghahghaei-Nezamabadi Akram, Ghaemi Marjan, Karimi Rana
Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Family Reprod Health. 2025 Jun;19(2):106-110. doi: 10.18502/jfrh.v19i2.19298.
This study aimed to evaluate the prognostic value of the progesterone challenge test (PCT) in the diagnosis of hyperplastic and cancerous endometrium in high-risk postmenopausal women.
In this cross-sectional study, 72 postmenopausal women without abnormal uterine bleeding who had risk factors for endometrial cancer were recruited. Patients with endometrial thickness of 4 mm or more as determined transvaginal ultrasonography were tested with progesterone challenge test. If there were any bleeding (spotting to severe bleeding) in the next two weeks, the test would be considered positive. After two weeks, all of the participants despite the result of PCT underwent office endometrial biopsy. In the end, all the results of PCT were compared with endometrial biopsy results.
The mean age of the participants was 57.7 ±8.15 years. The progesterone challenge test was positive in 17 women (22%). Among the participants with positive progesterone challenge test, most of them show hyperplasia (62.5%) and 4.2% show endometrial cancer. According to the results, PCT had 37.5% accuracy, 20.8% sensitivity, 70.8 % specificity, 58.8% positive predictive value (PPV), and 30.9 % negative predictive value (NPV) for diagnosis of endometrial pathology.
We suggest that due to the unacceptable sensitivity and specificity of the PCT, this test alone is not suitable for screening of endometrial cancer or hyperplasia.
本研究旨在评估孕激素激发试验（PCT）在高危绝经后女性增生性和癌性子宫内膜诊断中的预后价值。
在这项横断面研究中，招募了72名无子宫异常出血但有子宫内膜癌风险因素的绝经后女性。经阴道超声检查确定子宫内膜厚度为4mm或以上的患者接受孕激素激发试验。如果在接下来的两周内有任何出血（点滴出血至严重出血），则该试验被视为阳性。两周后，所有参与者无论孕激素激发试验结果如何均接受门诊子宫内膜活检。最后，将所有孕激素激发试验结果与子宫内膜活检结果进行比较。
参与者的平均年龄为57.7±8.15岁。17名女性（22%）的孕激素激发试验呈阳性。在孕激素激发试验阳性的参与者中，大多数表现为增生（62.5%），4.2%表现为子宫内膜癌。根据结果，孕激素激发试验在诊断子宫内膜病变方面的准确率为37.5%，敏感性为20.8%，特异性为70.8%，阳性预测值（PPV）为58.8%，阴性预测值（NPV）为30.9%。
我们认为，由于孕激素激发试验的敏感性和特异性不理想，单独使用该试验不适合筛查子宫内膜癌或增生。
