PSAP and neoplasm: Additionally, high PSAP expression is more common in CRC patients with dMMR (deficient mismatch repair), CIMP+ (CpG island methylator phenotype) status, and BRAF mutations, which are molecular features that collectively enhance tumor aggressiveness and cause poor prognosis: dMMR leads to mutation accumulation due to defective DNA repair; CIMP+ silences tumor suppressor genes via hypermethylation; and BRAF mutations activate pro-proliferative signaling pathways.