10-87960892-A-T

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PVS1PM2PS4_Supporting

This summary comes from the ClinGen Evidence Repository: PTEN c.802-2A>T (IVS7-2A>T) meets criteria to be classified as pathogenic for PTEN Hamartoma Tumor syndrome in an autosomal dominant manner using modified ACMG criteria (Mester et al. 2018; manuscript in preparation). Please see a summary of the rules and criteria codes in the “PTEN ACMG Specifications Summary” document (assertion method column).PVS1: Null variant predicted to result in nonsense-mediated decay or causing truncation/frameshift at or 5’ to c.1121 (NM_000314.4).PM2: Absent in large sequenced populations (PMID 27535533).PS4_P: Proband(s) with phenotype specificity score of 1-1.5. (Internal laboratory contributor(s), SCV000222230.9) LINK:https://erepo.genome.network/evrepo/ui/classification/CA000591/MONDO:0017623/003

Frequency

Genomes: 𝑓 0.000042 ( 0 hom., cov: 30)
Exomes 𝑓: 0.00011 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

PTEN
NM_000314.8 splice_acceptor

Scores

5
1
1
Splicing: ADA: 1.000
2

Clinical Significance

Pathogenic reviewed by expert panel P:10

Conservation

PhyloP100: 8.81
Variant links:
Genes affected
PTEN (HGNC:9588): (phosphatase and tensin homolog) This gene was identified as a tumor suppressor that is mutated in a large number of cancers at high frequency. The protein encoded by this gene is a phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase. It contains a tensin like domain as well as a catalytic domain similar to that of the dual specificity protein tyrosine phosphatases. Unlike most of the protein tyrosine phosphatases, this protein preferentially dephosphorylates phosphoinositide substrates. It negatively regulates intracellular levels of phosphatidylinositol-3,4,5-trisphosphate in cells and functions as a tumor suppressor by negatively regulating AKT/PKB signaling pathway. The use of a non-canonical (CUG) upstream initiation site produces a longer isoform that initiates translation with a leucine, and is thought to be preferentially associated with the mitochondrial inner membrane. This longer isoform may help regulate energy metabolism in the mitochondria. A pseudogene of this gene is found on chromosome 9. Alternative splicing and the use of multiple translation start codons results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Feb 2015]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PVS1
PS4
PM2

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
PTENNM_000314.8 linkuse as main transcriptc.802-2A>T splice_acceptor_variant ENST00000371953.8
PTENNM_001304717.5 linkuse as main transcriptc.1321-2A>T splice_acceptor_variant
PTENNM_001304718.2 linkuse as main transcriptc.212-2A>T splice_acceptor_variant

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
PTENENST00000371953.8 linkuse as main transcriptc.802-2A>T splice_acceptor_variant 1 NM_000314.8 P1P60484-1

Frequencies

GnomAD3 genomes
AF:
0.00
AC:
5
AN:
119978
Hom.:
0
Cov.:
30
FAILED QC
Gnomad AFR
AF:
0.0000310
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.000297
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000355
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000507
AC:
9
AN:
177630
Hom.:
0
AF XY:
0.0000512
AC XY:
5
AN XY:
97728
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000136
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.000195
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.000171
Gnomad NFE exome
AF:
0.0000119
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.000110
AC:
127
AN:
1155290
Hom.:
0
Cov.:
34
AF XY:
0.000106
AC XY:
61
AN XY:
577280
show subpopulations
Gnomad4 AFR exome
AF:
0.0000394
Gnomad4 AMR exome
AF:
0.000237
Gnomad4 ASJ exome
AF:
0.000140
Gnomad4 EAS exome
AF:
0.000122
Gnomad4 SAS exome
AF:
0.0000798
Gnomad4 FIN exome
AF:
0.000282
Gnomad4 NFE exome
AF:
0.0000994
Gnomad4 OTH exome
AF:
0.000104
GnomAD4 genome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.0000417
AC:
5
AN:
120000
Hom.:
0
Cov.:
30
AF XY:
0.0000520
AC XY:
3
AN XY:
57696
show subpopulations
Gnomad4 AFR
AF:
0.0000309
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.000297
Gnomad4 NFE
AF:
0.0000355
Gnomad4 OTH
AF:
0.00

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:10
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

PTEN hamartoma tumor syndrome Pathogenic:3
Pathogenic, reviewed by expert panelcurationClingen PTEN Variant Curation Expert Panel, ClingenOct 18, 2017PTEN c.802-2A>T (IVS7-2A>T) meets criteria to be classified as pathogenic for PTEN Hamartoma Tumor syndrome in an autosomal dominant manner using modified ACMG criteria (Mester et al. 2018; manuscript in preparation). Please see a summary of the rules and criteria codes in the 'PTEN ACMG Specifications Summary' document (assertion method column). PVS1: Null variant predicted to result in nonsense-mediated decay or causing truncation/frameshift at or 5' to c.1121 (NM_000314.4). PM2: Absent in large sequenced populations (PMID 27535533). PS4_P: Proband(s) with phenotype specificity score of 1-1.5. (Internal laboratory contributor(s), SCV000222230.9) -
Pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineDec 11, 2019The c.802-2A>T variant in PTEN has been reported in 1 individual with Cowden syndrome (Nizialek 2015). It has also been identified in 0.02% (2/11304) of East Asian chromosomes by gnomAD (http://gnomad.broadinstitute.org).This variant was classified as Pathogenic on 10/18/17 by the ClinGen-approved PTEN variant curation expert panel (Variation ID: 142423). This variant occurs in the invariant region (+/- 1,2) of the splice consensus sequence and is predicted to cause altered splicing leading to an abnormal or absent protein. Heterozygous loss-of-function of the PTEN gene is an established disease mechanism in individuals with PTEN hamartoma tumor syndrome. In summary, this variant meets our criteria to be classified as pathogenic for PTEN hamartoma tumor syndrome in an autosomal dominant manner. ACMG/AMP Criteria applied: PVS1, PM2, PS4_Supporting. -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpSep 14, 2023This sequence change affects an acceptor splice site in intron 7 of the PTEN gene. RNA analysis indicates that disruption of this splice site induces altered splicing and may result in an absent or disrupted protein product. The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. Disruption of this splice site has been observed in individuals with Cowden syndrome (PMID: 27477328, 28677221; Invitae). ClinVar contains an entry for this variant (Variation ID: 142423). Studies have shown that disruption of this splice site results in activation of a cryptic splice site and introduces a premature termination codon (PMID: 28677221; Invitae). The resulting mRNA is expected to undergo nonsense-mediated decay. For these reasons, this variant has been classified as Pathogenic. -
not provided Pathogenic:3
Pathogenic, criteria provided, single submitterclinical testingInstitute of Medical Genetics and Applied Genomics, University Hospital TübingenOct 23, 2020- -
Pathogenic, criteria provided, single submitterclinical testingCenter for Genomic Medicine, Rigshospitalet, Copenhagen University HospitalAug 15, 2023- -
Pathogenic, criteria provided, single submitterclinical testingGeneDxOct 24, 2023Canonical splice site variant demonstrated to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease (Chen et al., 2017); Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 28677221, 25669429, 22005521, 28152038, 30311380, 32710294, 33258288, 36453251) -
Cowden syndrome 1 Pathogenic:2
Pathogenic, no assertion criteria providedresearchCancer Genomic Medicine Translational Research Lab, Cleveland Clinic Genomic Medicine InstituteMay 26, 2017- -
Pathogenic, criteria provided, single submitterclinical testingMyriad Genetics, Inc.May 10, 2023This variant is considered pathogenic. This variant occurs within a consensus splice junction and is predicted to result in abnormal mRNA splicing of either an out-of-frame exon or an in-frame exon necessary for protein stability and/or normal function. This variant has been reported in multiple individuals with clinical features of gene-specific disease [PMID: 28677221, 28013114]. mRNA analysis has demonstrated abnormal mRNA splicing occurs [PMID: 28677221]. -
PTEN-related disorder Pathogenic:1
Pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesJul 25, 2024The PTEN c.802-2A>T variant is predicted to disrupt the AG splice acceptor site and interfere with normal splicing. This variant has been reported in individuals with PTEN hamartoma tumor syndrome (PHTS; Table S4, Nizialek et al. 2015. PubMed ID: 25669429; Table 1, Wang et al. 2022. PubMed ID: 36453251). This variant is reported in 0.018% of alleles in individuals of East Asian descent in gnomAD. It is interpreted as pathogenic by the ClinGen PTEN Variant Curation Expert Panel in ClinVar (https://preview.ncbi.nlm.nih.gov/clinvar/variation/142423/). Variants that disrupt the consensus splice acceptor site in PTEN are expected to be pathogenic. An alternate A-to-G nucleotide change at this acceptor site has been reported to be associated with PHTS (Table 1, Chen et al. 2017. PubMed ID: 28677221; https://preview.ncbi.nlm.nih.gov/clinvar/variation/189509/). The c.802-2A>T variant is interpreted as pathogenic. -
Hereditary cancer-predisposing syndrome Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsMay 23, 2023The c.802-2A>T intronic pathogenic mutation results from an A to T substitution two nucleotides upstream from coding exon 8 in the PTEN gene. This alteration segregated with disease in one PTEN hamartoma tumor syndrome (PHTS) family tested at our laboratory (Ambry internal data). This mutation has also been detected in cohorts of patients who met clinical diagnostic criteria for Cowden syndrome (CS) or relaxed clinical diagnostic criteria for CS-like (Nizialek EA et al. Eur. J. Hum. Genet. 2015 Nov;23:1538-43; Chen HJ et al. Hum. Mutat., 2017 10;38:1372-1377). In addition to the clinical data presented in the literature, alterations that disrupt the canonical splice site are expected to cause aberrant splicing, resulting in an abnormal protein or a transcript that is subject to nonsense-mediated mRNA decay. RNA studies have demonstrated that this variant results in abnormal splicing with out-of-frame deletion of 43 nucleotides from the beginning of coding exon 8 through use of a cryptic acceptor site (Ambry internal data; Chen HJ et al. Hum. Mutat., 2017 10;38:1372-1377). As such, this alteration is classified as a disease-causing mutation. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.27
D
BayesDel_noAF
Pathogenic
0.16
CADD
Pathogenic
36
DANN
Uncertain
0.99
Eigen
Pathogenic
1.1
Eigen_PC
Pathogenic
0.96
FATHMM_MKL
Pathogenic
1.0
D
MutationTaster
Benign
1.0
D
GERP RS
5.1

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.93
SpliceAI score (max)
1.0
Details are displayed if max score is > 0.2
DS_AG_spliceai
0.88
Position offset: 45
DS_AL_spliceai
1.0
Position offset: 2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs587782455; hg19: chr10-89720649; COSMIC: COSV64297401; API