| Objective:To study the role of inflammatory factors C-reactive protein(C-reactive protein)and interleukin-6(Interleukin6,IL-6)in the occurrence and development of prostate cancer,and to explore the possibility of CRP and IL-6 as indicators for diagnosis and prognosis of prostate cancer.Methods:A total of 139 patients with benign prostatic hyperplasia and prostate cancer diagnosed by histopathology in the second affiliated Hospital of Kunming Medical University from January 2013 to December 2019 were analyzed retrospectively,including 89 patients with prostate cancer and 50 patients with benign prostatic hyperplasia.General data such as patient’s age,BMI,family history of prostate cancer,smoking history and prostate Gleason score were collected.At the same time,the levels of circulating PSA,CRP and IL-6 before operation were collected,and the paraffin-embedded specimens of all patients after prostate puncture or operation were stained with CRP and IL-6 immunohistochemical staining,and the expression of CRP and IL-6 in different tissues was semi-quantitatively analyzed by IPP software.Results:There was no statistical difference between benign prostatic hyperplasia group and prostate cancer group in age,BMI,family history,smoking history and so on.There were statistical differences in circulating CRP between the two groups(prostate hyperplasia group:2.61 ±0.99,prostate cancer group:7.23±13.48,P=0.02);there were statistical differences in circulating IL-6 between the two groups(prostate hyperplasia group:2.79±3.46,prostate cancer group:5.05±7.14,P=0.014).Further analysis was carried out by using the ROC curve,the area under the cyclic CRP curve was 0.683,the 95%confidence interval was 0.597-0.770(P<0.001);The area under the cyclic IL-6 curve was 0.667,the 95%confidence interval was 0.575-0.758(P=0.001);The area under the circular PSA curve is 0.788.the 95%confidence interval is 0.714-0.862(P<0.001).The probability of the joint index of CRP and PSA is predicted by logistic multifactor analysis and the ROC curve is drawn.The area under the curve is 0.818,the 95%confidence interval is 0.746-0.889(P<0.001),and the prediction equation is(-0.317)*CRP+(·0.078)*PSA.In the special PSA interval(4-10ng/ml),there was no significant difference in CRP and IL-6 between the two groups(CRP:P=0.168.IL-6:P=0.651).There was significant difference in tissue expression of CRP between the two groups(P<0.001).In prostate cancer group,there was significant difference in Gleason score between group 1 and group 2,between group 2 and group 3,between group 3 and group 4,except between group 4 and group 5(P=0.028,P=0.032,P=0.01,P=0.373).There was significant difference between middle differentiation and low differentiation(P<0.001).There was significant difference in tissue expression of IL-6 between the two groups(P<0.001).In prostate cancer group,there was significant difference in Gleason score between group 4 and group 5(P<0.001),and between moderately differentiated and-poorly differentiated groups(P<0.004),but there was no significant difference in other groups.Conclusions:1.Inflammation,especially subclinical inflammation may play a role in the occurrence and development of prostate cancer.2.Circulating CRP and IL-6 levels can assist in the diagnosis of prostate cancer and help reduce unnecessary puncture.The combined use of CRP and PSA has better diagnostic value.3.CRP and IL-6 are highly expressed in prostate cancer specimens and are related to the occurrence of prostate cancer.4.The expression of CRP and IL-6 in low-differentiated cancer tissues is higher than that in moderately-differentiated cancer tissues,especially CRP and Gleason score are highly correlated.Detection of tissue CRP and IL-6 expression levels can help judge the prognosis of prostate cancer patients. |
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