Sohn Yeo Ju, Lee Sol, Kim Junghwa, Ryou Insun, Jeong Eunjin, Ryoo Jae-Hong, Chun Hyejin
Department of Family Medicine, Ewha Women's University Seoul Hospital, Ewha Women's University College of Medicine, Seoul 07804, Republic of Korea.
Department of Family Medicine, Ewha Women's University Mokdong Hospital, Ewha Women's University College of Medicine, Seoul 07985, Republic of Korea.
Cancers (Basel). 2025 Aug 23;17(17):2743. doi: 10.3390/cancers17172743.
BACKGROUND/OBJECTIVES: Proteinuria, a marker of renal dysfunction, has been implicated in cancer risk, yet its role in gastric carcinogenesis remains underexplored in high-incidence populations. This study evaluated the association between urine dipstick proteinuria severity and gastric cancer incidence in a nationwide Korean cohort.
We analyzed data from the Korean National Health Insurance Service-National Sample Cohort, including 220,941 adults aged > 40 years, without a diagnosis of cancer, who received health examinations in 2009. Proteinuria was classified by single dipstick testing as negative, 1+, or ≥2+. Participants were followed for a mean of 4.37 ± 0.49 years (965,601.2 person-years). Multivariable Cox proportional hazards models adjusted for age, sex, body mass index, systolic blood pressure, fasting glucose, LDL cholesterol, estimated glomerular filtration rate, smoking status, alcohol intake, and physical activity were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
During follow-up, 1934 participants (0.88%) developed gastric cancer. A significant dose-response relationship emerged ( for trend = 0.037). In fully adjusted models, 1+ proteinuria conferred no significant risk increase (HR 1.10; 95% CI, 0.80-1.51), whereas ≥2+ proteinuria was associated with a 42% higher gastric cancer risk (HR 1.42; 95% CI, 1.00-2.02).
Severe dipstick proteinuria independently predicts elevated gastric cancer risk in Korean adults. Integration of urine dipstick testing into gastric cancer screening protocols may offer a simple, cost-effective strategy for risk stratification, particularly in high-incidence settings.
背景/目的：蛋白尿作为肾功能不全的一个指标，与癌症风险相关，但其在胃癌高发人群的胃癌发生过程中的作用仍未得到充分研究。本研究评估了韩国全国队列中尿试纸法蛋白尿严重程度与胃癌发病率之间的关联。
我们分析了韩国国民健康保险服务全国样本队列的数据，包括2009年接受健康检查、年龄大于40岁且未被诊断患有癌症的220,941名成年人。蛋白尿通过单次尿试纸检测分为阴性、1+或≥2+。参与者平均随访4.37±0.49年（965,601.2人年）。使用多变量Cox比例风险模型，对年龄、性别、体重指数、收缩压、空腹血糖、低密度脂蛋白胆固醇、估计肾小球滤过率、吸烟状况、饮酒量和身体活动进行调整，以估计风险比（HR）和95%置信区间（CI）。
在随访期间，1934名参与者（0.88%）患胃癌。出现了显著的剂量反应关系（趋势P = 0.037）。在完全调整模型中，1+蛋白尿未显著增加风险（HR 1.10；95%CI，0.80 - 1.51），而≥2+蛋白尿与胃癌风险高42%相关（HR 1.42；95%CI，1.00 - 2.02）。
严重的尿试纸法蛋白尿可独立预测韩国成年人胃癌风险升高。将尿试纸检测纳入胃癌筛查方案可能为风险分层提供一种简单、经济有效的策略，特别是在高发地区。
