[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-384323-105":59,"doc-detail-384323-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","testing-for-decient-mismatch-repair-and-microsatellite-instability-a-focused-update","Testing for deficient mismatch repair and microsatellite instability - A focused update","","Testing to detect mismatch repair deficiency (dMMR) and high-grade microsatellite instability (MSI-H) is integral to routine colorectal cancer (CRC) diagnostics. While MSI initially suggested hereditary risk such as Lynch syndrome, current emphasis is on predicting response to immune checkpoint inhibitors (ICI), now expanded beyond CRC to additional non-CRC tumors. The review updates dMMR/MSI testing, focusing on challenges in interpreting MMR immunohistochemistry stains and PCR-based value under broader indications. It includes a practice-oriented decision flowchart that addresses discordances between MMR-IHC and MSI-PCR and considers next-generation sequencing, plus systematic quality assurance and continued training.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/testing-for-decient-mismatch-repair-and-microsatellite-instability-a-focused-update/384323/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/testing-for-decient-mismatch-repair-and-microsatellite-instability-a-focused-update/384323.png","ImageObject",300,407,{"name":92,"@type":93},"Anna Hans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the role of dMMR and MSI-H testing in routine colorectal cancer diagnostics?","Question",{"text":112,"@type":113},"Testing to detect dMMR and high-grade MSI (MSI-H) is an integral part of the routine diagnostic workup for colorectal cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How has the clinical focus of MSI changed from hereditary risk to therapy guidance?",{"text":117,"@type":113},"MSI was initially considered a possible indicator of hereditary predisposition such as Lynch syndrome, but today prediction of therapy response to immune checkpoint inhibitors is in the foreground.",{"name":119,"@type":110,"acceptedAnswer":120},"What kinds of challenges and discordances are addressed when comparing MMR-IHC and MSI-PCR results?",{"text":121,"@type":113},"The document highlights challenges in assessing immunohistochemical stains and discusses discordances between MMR-IHC and MSI-PCR, including classic, unusual, and complex findings, and the possible value of PCR and next-generation sequencing.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},384323,1790364240,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Die Pathologie  \nvormals Der Pathologe  \nSchwerpunkt: Kolorektales Karzinom-die Rolle der Pathologie  \nPathologie 2023 · 44 (Suppl 2):S61–S70  \n[https://doi.org/10.1007/s00292-023-01208-2](https://doi.org/10.1007/s00292-023-01208-2)  \nAccepted: 18 April 2023  \nPublished online: 24 October 2023  \n© The Author(s) 2023  \nSchwerpunktherausgeber  \nHendrik Bläker, Leipzig  \nTesting for deficient mismatch repair and microsatellite instability  \nA focused update  \nJosef Rüschoff1 · Hans-Ulrich Schildhaus1 · Jan Hendrik Rüschoff2 · Korinna Jöhrens3 · Tina Bocker Edmonston4 · Wolfgang Dietmaier5 · Hendrik Bläker6 · Gustavo Baretton3 · David Horst7 · Manfred Dietel7 · Arndt Hartmann8 · Frederick Klauschen9 ·  \nSabine Merkelbach-Bruse10 · Albrecht Stenzinger11 · Sandra Schöniger1 · Markus Tiemann12 · Wilko Weichert13 · Reinhard Büttner10  \n1 Discovery Life Sciences Biomarker GmbH and North Hesse Pathology, Kassel, Germany; 2 Institute of Pathology and Molecular Pathology, Zürich University Hospital, Zürich, Switzerland; 3 Institute of Pathology, Carl Gustav Carus University Hospital, Dresden, Germany; 4 Department of Pathology, Cooper University Health Care, Camden, USA; 5 Institute of Pathology/Center for Molecular Pathology Diagnosis, University of Regensburg, Regensburg, Germany; 6 Institute for Pathology, Leipzig University Hospital, Leipzig, Germany; 7 Institute of Pathology, Charité University Hospital, Central Campus, Berlin, Germany; 8 Pathological Institute, University of Erlangen-Nuremberg, Erlangen, Germany; 9 Pathological Institute, Ludwig Maximilian University of Munich, Munich, Germany; 10 Institute of Pathology, Cologne University Hospital, Cologne, Germany; 11 Pathological Institute, Heidelberg University Hospital, Heidelberg, Germany; 12 Hamburg Institute of Hematopathology, Hamburg, Germany; 13 Institute of Pathology, Technical University of Munich, Munich, Germany  \nIn this article  \n– Significance of MMR-IHC and MSI-PCR in different organ systems  \n– Classic dMMR findings  \n– Unusual dMMR findings  \nIsolated loss of PMS2 or MSH6 · Discordance between MMR-IHC and MSI-PCR · Complex findings on IHC  \n– Update on step-by-step assessment of MMR-IHC  \n– Practical conclusion  \nThe author Prof. Wilko Weichert (†10 .07.2023) unfortunately passed away before this article was published. The article is dedicated to him in honorable memory.  \n\n| \u003Cbr>Abstract |\n| --- |\n| Testing to detect mismatch repair deficiency (dMMR) and high-grade microsatellite instability (MSI-H) has become an integral part of the routine diagnostic workup for colorectal cancer (CRC) . While MSI was initially considered to be a possible indicator of a hereditary disposition to cancer (Lynch syndrome, LS), today the prediction of the therapy response to immune checkpoint inhibitors (ICI) is in the foreground. Corresponding recommendations and testing algorithms are available for use in primary diagnosis (reviewed in: Rüschoff et al. 2021) .\u003Cbr>Given the increasing importance for routine use and the expanding indication spectrum of ICI therapies for non-CRCs, such as endometrial, small intestinal, gastric, and biliary tract cancers, an updated review of dMMR/MSI testing is presented. The focus is on the challenges in the assessment of immunohistochemical stains and the value of PCR-based procedures, considering the expanded ICI indication spectrum. A practice-oriented flowchart for everyday diagnostic decision-making is provided that considers new data on the frequency and type of discordances between MMR-IHC and MSI-PCR findings, and the possible role of Next Generation Sequencing in clarifying them. Reference is made to the significance of systematic quality assurance measures (e.g., QuIP MSI portal and multicenter proficiency testing), including regular continued training and education.\u003Cbr>Keywords\u003Cbr>Hereditary nonpolyposis colorectal neoplasms · High-throughput nucleotide sequencing · MMR immunohistochemistry · Immune checkpoint inhibitors · Lynch syndrome |\n\nSupplemen","cbCaiv2XImjBpFMb","https://ap.wps.com/l/cbCaiv2XImjBpFMb","pdf",6749098,"English","# Significance of MMR-IHC and MSI-PCR in different organ systems\n## Classic dMMR findings\n## Unusual dMMR findings\n## Update on step-by-step assessment of MMR-IHC\n## Practical conclusion","[{\"question\":\"What is the role of dMMR and MSI-H testing in routine colorectal cancer diagnostics?\",\"answer\":\"Testing to detect dMMR and high-grade MSI (MSI-H) is an integral part of the routine diagnostic workup for colorectal cancer.\"},{\"question\":\"How has the clinical focus of MSI changed from hereditary risk to therapy guidance?\",\"answer\":\"MSI was initially considered a possible indicator of hereditary predisposition such as Lynch syndrome, but today prediction of therapy response to immune checkpoint inhibitors is in the foreground.\"},{\"question\":\"What kinds of challenges and discordances are addressed when comparing MMR-IHC and MSI-PCR results?\",\"answer\":\"The document highlights challenges in assessing immunohistochemical stains and discusses discordances between MMR-IHC and MSI-PCR, including classic, unusual, and complex findings, and the possible value of PCR and next-generation sequencing.\"}]","Testing for deficient mismatch repair and microsatellite instability - A focused update | PDF",1790262202,25]