The Role of Serum and Urine CRP Levels in Predicting Pathology Results in Patients Undergoing Prostate Biopsy

Objective: The definitive diagnosis of prostate cancer, the second most common cancer in men, relies on histopathological examination of tissue obtained through prostate biopsy. Prostate biopsy, typically performed transrectally and occasionally via transperineal routes, carries a range of complication risks from psychological stress to hematuria and urosepsis. Avoiding unnecessary prostate biopsies is crucial. In this context, CRP, an inflammatory marker, may help prevent unnecessary biopsies related to PSA increases due to non-neoplastic local inflammatory causes. Based on this hypothesis, our study aimed to evaluate the role of urine and serum CRP levels in predicting possible pathology results (BPH, chronic prostatitis, and PCa) in patients planned for prostate biopsy. Materials and Methods: A total of 251 patients who presented to the urology clinic at Istanbul Training and Research Hospital between 01/09/2023 and 31/01/2023 and underwent biopsy were included in the study. Patients had normal urine tests at presentation, serum total PSA levels between 2.5-10 ng/dl, and normal digital rectal examination findings. Urine and blood samples were collected to determine pre-biopsy CRP levels, which were centrifuged and stored at -80 degrees; appropriate serum and urine kits were used for analysis. Following this, TRUS-Bx was performed under suitable conditions. Based on histopathological results, patients were divided into three groups: BPH, chronic prostatitis, and PCa. Measurements and evaluations were conducted regarding comorbidities (HT, CVD, COPD, DM, etc.), BMI, smoking status, PSA, PV, and urine and serum CRP levels. Results were analyzed statistically, and comparisons among the groups were made. Results: When examining the relationship between demographic characteristics, comorbidity groups, and CRP levels, no significant difference was found in serum and urine CRP levels (p>0.05). In the histopathological subgroup analysis (BPH, chronic inflammation, PCa), it was observed that urine and serum CRP levels were not related to comorbidity, weight, height, BMI, or smoking status (p>0.05). While a significant difference was observed in PV among the three groups (P=0.00), no difference was found regarding PSA levels. No significant difference was determined in serum and urine CRP levels among the three study groups. Conclusion : According to the findings of our study, urine and serum CRP levels prior to TRUS-BX for suspected prostate cancer do not provide additional benefit in predicting benign or malignant pathology results. Nonetheless, further larger and comprehensive studies supported by advanced imaging techniques are needed.