Presence of tumoural C-reactive protein correlates with progressive prostate cancer

Abstract

C-reactive protein (CRP) is an acute phase protein implicated in the progression of cancer. A positive correlation between tumour stage and plasma CRP levels was demonstrated in prostate cancer, indicating a relationship between raised CRP levels and more aggressive disease, suggesting a role for inflammatory response in tumour progression. Aim of this study was to assess the tumoural presence and cellular location of CRP and establish if these are linked to clinicopathological features of the cohort and patient survival. Tissue microarray technology was employed to analyse 50 matched pairs of hormone sensitive and refractory prostate cancers. Immunohistochemistry was performed using antibody to CRP. CRP was assessed using the weighted histoscore method. CRP presence was observed in the cytoplasm and nucleus of selected tumours. Cytoplasmic CRP correlated positively with metastases at diagnosis (P=0.039), whereas nuclear CRP presence correlated with metastases at relapse (P=0.006). A trend towards an increase in cytoplasmic and nuclear CRP presence from hormone sensitive to hormone refractory tumours was noticed. No significant association between tumoural CRP presence, time to biochemical relapse or disease-specific survival was observed. Tumoural CRP is likely to have a role in progression of prostate cancer, as it is associated with increased presence of metastases at the time of diagnosis and time of relapse. A larger powered study is necessary to establish if CRP presence is associated with disease-specific survival.