In order to evaluate the difference in aggressiveness between GS (3 + 4) and GS (4 + 3), we compared SPP1 and CP among BPH combined with GS 6, GS 7(3 + 4), GS 7(4 + 3) and GS 8, 9 groups, significant differences were observed in serum SPP1 concentration among comparison groups (0.057 vs. 0.087 vs. 1.122 vs. 1.132 μg/mL, p=0.012), which indicated a increasing trend of the SPP1 concentration in PCa with higher Gleason grade. Here, CP is linked to benign prostatic hyperplasia.