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. Methods: 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). Results: During follow-up, 1934 participants (0.88%) developed gastric cancer. A significant dose–response relationship emerged (pfor 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). Conclusions: 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：蛋白尿作为肾功能障碍的标志物，已被认为与癌症风险相关，但其在高发病率人群胃癌发生中的作用尚未得到充分研究。本研究旨在评估韩国全国性队列中尿试纸蛋白尿严重程度与胃癌发病率之间的关联。方法：我们分析了韩国国民健康保险服务-国家样本队列的数据，纳入2009年接受健康检查的220,941名40岁以上、无癌症诊断的成年人。通过单次试纸检测将蛋白尿分为阴性、1+或≥2+。参与者平均随访4.37±0.49年（合计965,601.2人年）。采用多变量Cox比例风险模型，调整年龄、性别、体重指数、收缩压、空腹血糖、低密度脂蛋白胆固醇、估算肾小球滤过率、吸烟状况、饮酒量和体力活动等因素，计算风险比（HR）及其95%置信区间（CI）。结果：随访期间，1934名参与者（0.88%）罹患胃癌。存在显著的剂量-反应关系（趋势性p值=0.037）。在完全调整的模型中，1+蛋白尿未显著增加风险（HR 1.10；95% CI，0.80-1.51），而≥2+蛋白尿与胃癌风险升高42%相关（HR 1.42；95% CI，1.00-2.02）。结论：严重试纸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，尤其适用于高发病率地区。
肿瘤(癌症)患者之家