for example , stomach , liver , and colon cancer are common in patients with inflammatory colitis .
there is considerable correlation between the prognosis of various cancers and specific inflammatory markers and cytokines as well as systemic , nonspecific inflammatory markers such as c - reactive protein ( crp ) .
crp is a general marker of inflammation , and it is known to be correlated with cancer risks . also , crp is reported to have usability as a biomarker in urologic cancer .
for example , elevation of crp levels , which indicates the presence of a cancer - associated systemic inflammatory response , is linked to lower survival in patients with urologic cancers , including renal cell carcinoma and cancers of upper urinary tract , bladder , and prostate .
inflammation has been shown in prostate biopsy tissues , prostatectomy specimens , and chips from transurethral resection of the prostate .
the existence of crp can be checked through immunochemical examination of the cytoplasm and nucleus of prostate cancer tissue .
macrophage inhibitory cytokine-1 ( mic-1 ) , also known as prostate - derived factor , is a molecule of the transforming growth factor- super family and has been associated with the progression of various types of diseases , including prostate cancer .
inflammation - associated cytokines may play a critical role in the functional regulation of the mic-1 gene in the early stages of prostate cancer development .
prostate cancer cell - induced cytokine production by peripheral blood mononuclear cells ( pbmcs ) and interleukin ( il)-6 is involved in the development of prostate cancers .
pbmcs are capable of carrying out an " immune - modulatory dialogue " with colon cancer cells expressed by an increased production of proinflammatory cytokines by the pbmcs . the expression of il-7 and il-15 genes in prostate tissue and corresponding serum titers are significantly increased in patients with early stage prostate cancer as compared with patients with benign prostatic hyperplasia ( bph ) .
analysis of the results of recent articles suggests that inflammation influences the occurrence of prostate cancer .
we hypothesized that a correlation may exist between inflammation and prostate cancer according to the serum crp level in patients undergoing transrectal biopsy of the prostate because of a rising prostate - specific antigen ( psa ) level .
from january 2009 to march 2012 , we retrospectively reviewed 710 patients who visited our urology department and were diagnosed as having psa over 4.0 ng / ml and prostate volume over 20 ml .
patients who had acute infections , rheumatoid arthritis , gout , asthma , chronic lung disease , myocardial infarction , or apoplexy or who had taken nonsteroidal anti - inflammatory drugs were exempted from the research because these variables can impact crp . after we applied the exclusion criteria , we chose 63 patients with prostate cancer and 140 patients with bph for the case - control analysis .
the 63 patients are diagnosed with prostate cancer underwent computed tomography , magnetic resonance imaging , and bone scan .
twenty - six patients underwent radical retropubic prostatectomy and one patient underwent a pelvic lymph node dissection .
also , prostate cancer was found in two patients after transurethral resection of the prostate .
the clinical stage of prostate cancer was described by the tumor - node - metastasis ( tnm ) stage , and the prostate cancer patients were classified into two groups according to the tnm classification .
patients below t2 were assigned to group a , and patients above t3 were assigned to group b. we used t - tests to examine the correlation between crp and bph and prostate cancer .
we conducted analysis of variance inspection to compare the crp level of the bph group , prostate cancer group a , and prostate cancer group b. a p - values below 0.05 indicated statistical significance .
the turbid immune assay was used to measure high - sensitivity crp ( hs - crp ) .
we designated the results in mg / l , and the limit of determination was 0.02
the crp level was determined by the natural logarithm of c - reactive protein ( lncrp ) level .
their average age was 64.59.28 years ( meanstandard deviation [ sd ] ; range , 44 to 91 years ) .
the average age of the 140 bph patients was 62.29.04 years ( range , 48 to 91 years ) .
the average age of the 63 prostate cancer patients was 67.28.98 years ( range , 44 to 79 years ) .
prostate cancer stages were distributed as follows : 2 patients t1 , 41 patients t2 , 9 patients t3 , and 11 patients t4 .
there was a statistically significant difference between the two groups ( p<0.05 ) ( fig .
1 ) . considering the prostate cancer stages , the mean lncrp level of prostate cancer group a was 5.091.38 mg / l , and that of group b was 5.241.58
. the mean lncrp level of the bph group differed from the lncrp level of group a ( p<0.05 ) .
there was also a significant difference in lncrp level between the bph group and prostate cancer group b ( p<0.05 ) ( fig .
2 ) . there was no correlation between psa and crp level ( p=0.12 ) .
even though a causal role of chronic inflammation , recurrent inflammation , or infection is not yet established in prostate cancer , inflammation is considered to contribute to the carcinogenesis process .
the role of inflammation includes effects on cytokines and growth factors that participate in tumor growth , the induction of cyclooxygenase-2 in macrophages and the epithelium , and , last , generation of reactive oxygen species causing mutation and nitro - oxidant materials related to tumor growth .
infiltration of chronic inflammation is very common in the peripheral zone of the prostate where most prostate cancer occurs .
although differing in histology and medical terminology , show epithelial cell proliferation as a group . in these lesions ,
the heterogeneous expression of the gstp1 gene is likely to be damaged by oxygen . in a study in genetically modified mice that develop prostate cancer ,
the incidence of prostate cancer was significantly lower in mice supplemented with celecoxib , a cox-2 inhibitor , than in mice not given celecoxib .
the results of this study suggest that celecoxib may have a role in chemoprevention of prostate cancer .
also , it shows that controlling inflammation can reduce the occurrence of cancer . a positive correlation between serum crp and tumor stage
a correlation is also observed between the rise crp and faster progression of the tumor .
in addition , this study confirmed the existence of crp in the cytoplasm and nucleus of prostate cancer patients by immunochemical test .
crp is clearly an independent predicting factor of cancer - specific survival in prostate cancer patients .
crp is clearly confirmed as a factor predicting overall survival of castration - resistant prostate cancer patients treated with docetaxel . rising plasma crp suggests a poor prognosis .
future prospective study should include a larger population of patients for more accurate results . to classify pathological inflammation levels ,
the serum hs - crp level of the prostate cancer group was higher than that of the bph group .
inflammation may be correlated with prostate cancer on the basis of the serum hs - crp level .
 purposec - reactive protein ( crp ) is a general marker for inflammation and it has been associated with prostate cancer . 
 we hypothesized that a correlation may exist between crp and prostate cancer in patients undergoing transrectal biopsy of the prostate because of rising prostate - specific antigen ( psa ) levels.materials and methodsfrom january 2009 to march 2012 , we retrospectively reviewed 710 patients who visited our urology department and were diagnosed as having a psa value over 4.0 ng / ml . 
 patients with acute infections , rheumatoid arthritis , gout , asthma , chronic lung disease , myocardial infarction , or apoplexy and those who had taken nonsteroidal anti - inflammatory drugs were exempted from the research because these variables could have impacted crp . 
 after we applied the exclusion criteria , we selected 63 patients with prostate cancer and 140 patients with benign prostatic hyperplasia ( bph).resultsa total of 203 patients were observed : 140 patients had bph , and 63 patients had prostate cancer . 
 prostate cancer patients were divided into two groups by tumor - node - metastasis classification . 
 the patients below t2 were group a , and those above t3 were group b. the natural logarithm of c - reactive protein ( lncrp ) differed between the bph group and the prostate cancer group . 
 the lncrp also differed between the bph group and prostate cancer groups a and b ( p<0.05).conclusionsthe serum crp level of the prostate cancer group was higher than that of the bph group . 
 inflammation may be correlated with prostate cancer according to the serum crp level . 
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSIONS