{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T17:05:23Z","timestamp":1779555923392,"version":"3.53.1"},"reference-count":28,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Pathology - Research and Practice"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.prp.2026.156521","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:53:19Z","timestamp":1778547199000},"page":"156521","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Preoperative MMR testing in colorectal cancer: Large-scale cohort confirms reliability but identifies tumor heterogeneity as a challenge"],"prefix":"10.1016","volume":"284","author":[{"given":"Shun","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenyan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai","family":"lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuwen","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"12","key":"10.1016\/j.prp.2026.156521_bib1","article-title":"Neoadjuvant immunotherapy for dMMR and pMMR colorectal cancers: therapeutic strategies and putative biomarkers of response","volume":"21","author":"Christopher","year":"2024","journal-title":"Nat. Rev. Clin. Oncol."},{"issue":"10513","key":"10.1016\/j.prp.2026.156521_bib2","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/S0140-6736(25)01917-8","article-title":"Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.","volume":"406","year":"2025","journal-title":"Lancet"},{"issue":"21","key":"10.1016\/j.prp.2026.156521_bib3","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1056\/NEJMoa2400634","article-title":"Neoadjuvant Immunotherapy in Locally Advanced Mismatch Repair-Deficient Colon Cancer","volume":"390","author":"Chalabi","year":"2024","journal-title":"N. Engl. J. Med"},{"issue":"9927","key":"10.1016\/j.prp.2026.156521_bib4","article-title":"Colorectal cancer","volume":"383","author":"Hermann","year":"2013","journal-title":"Lancet"},{"issue":"3","key":"10.1016\/j.prp.2026.156521_bib5","article-title":"Interpreting and integrating genomic tests results in clinical cancer care: Overview and practical guidance","volume":"74","author":"Raffaella","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"10.1016\/j.prp.2026.156521_bib6","doi-asserted-by":"crossref","DOI":"10.1038\/s41586-025-09679-4","article-title":"Neoadjuvant immunotherapy in mismatch-repair-proficient colon cancers","author":"Tan","year":"2025","journal-title":"Nature"},{"issue":"4","key":"10.1016\/j.prp.2026.156521_bib7","article-title":"Neoadjuvant immunotherapy leads to pathological responses in MMR-proficient and MMR-deficient early-stage colon cancers","volume":"26","author":"Myriam","year":"2020","journal-title":"Nat. Med"},{"issue":"6","key":"10.1016\/j.prp.2026.156521_bib8","doi-asserted-by":"crossref","first-page":"366","DOI":"10.6004\/jnccn.2024.0041","article-title":"NCCN Guidelines\u00ae Insights: Rectal Cancer, Version 3.2024","volume":"22","author":"Benson","year":"2024","journal-title":"J. Natl. Compr. Canc Netw."},{"issue":"12","key":"10.1016\/j.prp.2026.156521_bib9","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1001\/jamaoncol.2023.3323","article-title":"Neoadjuvant Immune Checkpoint Inhibitor Therapy for Localized Deficient Mismatch Repair Colorectal Cancer: A Review","volume":"9","author":"Emiloju","year":"2023","journal-title":"JAMA Oncol."},{"issue":"4","key":"10.1016\/j.prp.2026.156521_bib10","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.cell.2017.01.018","article-title":"Clonal Heterogeneity and Tumor Evolution: Past, Present, and the Future","volume":"168","author":"McGranahan","year":"2017","journal-title":"Cell"},{"issue":"2","key":"10.1016\/j.prp.2026.156521_bib11","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/path.6228","article-title":"Genetic and immune landscape evolution in MMR-deficient colorectal cancer","volume":"262","author":"Challoner","year":"2024","journal-title":"J. Pathol."},{"issue":"12","key":"10.1016\/j.prp.2026.156521_bib12","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1038\/s41588-019-0525-5","article-title":"The mutational footprints of cancer therapies","volume":"51","author":"Pich","year":"2019","journal-title":"Nat. Genet"},{"issue":"5","key":"10.1016\/j.prp.2026.156521_bib13","doi-asserted-by":"crossref","first-page":"414","DOI":"10.3109\/00313025.2010.493862","article-title":"DNA mismatch repair enzyme immunohistochemistry in colorectal cancer: a comparison of biopsy and resection material","volume":"42","author":"Kumarasinghe","year":"2010","journal-title":"Pathology"},{"issue":"3","key":"10.1016\/j.prp.2026.156521_bib14","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/PAS.0b013e31820a091d","article-title":"Immunohistochemical staining for DNA mismatch repair proteins in intestinal tract carcinoma: how reliable are biopsy samples?","volume":"35","author":"Shia","year":"2011","journal-title":"Am. J. Surg. Pathol."},{"issue":"10","key":"10.1016\/j.prp.2026.156521_bib15","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1016\/j.humpath.2014.07.005","article-title":"How reliable is immunohistochemical staining for DNA mismatch repair proteins performed after neoadjuvant chemoradiation?","volume":"45","author":"Vilkin","year":"2014","journal-title":"Hum. Pathol."},{"issue":"1","key":"10.1016\/j.prp.2026.156521_bib16","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5114\/pjp.2020.95411","article-title":"The concordance of DNA mismatch repair protein between endoscopic biopsies and surgical specimens and inter-observers variations in colorectal cancer patients: reflections from endoscope doctors","volume":"71","author":"Guo","year":"2020","journal-title":"Pol. J. Pathol."},{"issue":"2","key":"10.1016\/j.prp.2026.156521_bib17","doi-asserted-by":"crossref","first-page":"166","DOI":"10.5858\/arpa.2013-0231-CP","article-title":"Template for reporting results of biomarker testing of specimens from patients with carcinoma of the colon and rectum","volume":"138","author":"Bartley","year":"2014","journal-title":"Arch. Pathol. Lab Med"},{"issue":"11","key":"10.1016\/j.prp.2026.156521_bib18","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1038\/s41379-022-01109-4","article-title":"Detecting mismatch repair deficiency in solid neoplasms: immunohistochemistry, microsatellite instability, or both?","volume":"35","author":"Wang","year":"2022","journal-title":"Mod. Pathol."},{"issue":"0","key":"10.1016\/j.prp.2026.156521_bib19","article-title":"Heterogenous mismatch-repair status in colorectal cancer","volume":"9","author":"Patrick","year":"2014","journal-title":"Diagn. Pathol."},{"issue":"10","key":"10.1016\/j.prp.2026.156521_bib20","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1136\/jcp-2023-209089","article-title":"Head-to-head comparative study: evaluating three panels for MSI-PCR testing in patients with colorectal and gastric cancer","volume":"77","author":"Fu","year":"2024","journal-title":"J. Clin. Pathol."},{"issue":"3","key":"10.1016\/j.prp.2026.156521_bib21","doi-asserted-by":"crossref","DOI":"10.1002\/imt2.43","article-title":"Complex heatmap visualization","volume":"1","author":"Gu","year":"2022","journal-title":"Imeta"},{"issue":"49","key":"10.1016\/j.prp.2026.156521_bib22","doi-asserted-by":"crossref","DOI":"10.21105\/joss.02017","article-title":"ggalluvial: Layered Grammar for Alluvial Plots","volume":"5","author":"Brunson","year":"2020","journal-title":"J. Open Source Softw."},{"issue":"6","key":"10.1016\/j.prp.2026.156521_bib23","article-title":"Neoadjuvant Modified Infusional Fluorouracil, Leucovorin, and Oxaliplatin With or Without Radiation Versus Fluorouracil Plus Radiation for Locally Advanced Rectal Cancer: Updated Results of the FOWARC Study After a Median Follow-Up of 10 Years","volume":"43","author":"Jianwei","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"10.1016\/j.prp.2026.156521_bib24","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.humpath.2017.02.003","article-title":"Neoadjuvant therapy in microsatellite-stable colorectal carcinoma induces concomitant loss of MSH6 and Ki-67 expression","volume":"63","author":"Kuan","year":"2017","journal-title":"Hum. Pathol."},{"issue":"2","key":"10.1016\/j.prp.2026.156521_bib25","first-page":"76","article-title":"Immunohistochemistry staining for DNA mismatch repair proteins in endoscopic biopsies and the corresponding surgical specimen in colorectal cancer","volume":"117","author":"Mart\u00ednez Lapiedra","year":"2025","journal-title":"Rev. Esp. Enferm. Dig."},{"issue":"7","key":"10.1016\/j.prp.2026.156521_bib26","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1136\/jclinpath-2017-204946","article-title":"Correlation of immunohistochemical mismatch repair protein status between colorectal carcinoma endoscopic biopsy and resection specimens","volume":"71","author":"O'Brien","year":"2018","journal-title":"J. Clin. Pathol."},{"issue":"12","key":"10.1016\/j.prp.2026.156521_bib27","article-title":"Neoadjuvant therapy induces loss of MSH6 expression in colorectal carcinoma","volume":"34","author":"Fei","year":"2010","journal-title":"Am. J. Surg. Pathol."},{"issue":"0","key":"10.1016\/j.prp.2026.156521_bib28","article-title":"Microbiome-transcriptome-histology triad enhances survival risk stratification in multiple cancers","volume":"120","author":"Binsheng","year":"2025","journal-title":"Comput. Biol. Chem."}],"container-title":["Pathology - Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0344033826001743?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0344033826001743?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T16:43:47Z","timestamp":1779554627000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0344033826001743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":28,"alternative-id":["S0344033826001743"],"URL":"https:\/\/doi.org\/10.1016\/j.prp.2026.156521","relation":{},"ISSN":["0344-0338"],"issn-type":[{"value":"0344-0338","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Preoperative MMR testing in colorectal cancer: Large-scale cohort confirms reliability but identifies tumor heterogeneity as a challenge","name":"articletitle","label":"Article Title"},{"value":"Pathology - Research and Practice","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.prp.2026.156521","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier GmbH. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"156521"}}